Association between admission time and in-hospital mortality in acute aortic dissection patients: A retrospective cohort study |
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| Institution: | 1. Gachon University, College of Nursing, Incheon, South Korea;2. Office of Hospital Information, Seoul National University Hospital, Seoul, South Korea;3. Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University, College of Medicine, Incheon, South Korea;4. Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center, Seoul, South Korea;5. Chonnam National University, College of Nursing, Gwangju, South Korea;6. Department of Nursing, Hanyang University Medical Center, Seoul, South Korea;7. Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea;8. Gachon University Gil Medical Center, Incheon, South Korea;9. Mercer University, Georgia Baptist College of Nursing, Atlanta, USA;1. Department of Internal Medicine, Saint Vincent Hospital, Worcester, Massachusetts United States, 01608;2. Division of Pulmonary and Critical care, Mayo Clinic, Rochester, Minnesota, Massachusetts United States, 55902;3. Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India;1. Faculty of Medicine, Minia University, Minia, Egypt;2. Sulaiman Al Rajhi University, College of Medicine, Qassim, Saudi Arabia;3. Faculty of Medicine, Mansoura University, Mansoura, Egypt;4. Neurosurgery Department, El Sheikh Zayed Specialized Hospital, Giza, Egypt;1. Department of Intensive Care Unit, The Affiliated Provincial Hospital of Anhui Medical University, Hefei 23001, China;2. Department of Intensive Care Unit, Division of Life Science and Medicine, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, No.17, Lu Jiang Road, Hefei 23001, China;3. Department of Intensive Care Unit, Infectious Diseases Branch of Anhui Provincial Hospital, Hefei, Anhui, China;1. Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States;2. Department of Cardiovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States;3. University College Cork School of Medicine, College Road, Cork T12 K8AF, Ireland;1. Department of Critical Care Medicine, The First Affiliated Hospital, China Medical University, North Nanjing Street 155, Shenyang 110001, Liaoning Province, China;2. Department of Critical Care Medicine, The Sixth People’ s Hospital of Shenyang, South Heping Street 85,Shenyang, Liaoning Province, China;3. Department of infection, The Sixth People’ s Hospital of Shenyang, South Heping Street 85,Shenyang, Liaoning Province, China |
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| Abstract: | PurposeThis study aimed to evaluate the relationship between admission time and in-hospital mortality in acute aortic dissection (AAD) patients.MethodsThe risk factors of in-hospital clinical outcomes were retrospectively evaluated in patients with AAD. All the patients were enrolled from January to December 2017 and were divided into two groups depending on the time of admission: daytime admissions were conducted from 8: 00 to 17: 30 hours whereas, nighttime admissions were from 17: 30 to 8: 00 hours. The primary endpoints were in-hospital mortality. Univariate and multivariable cox analyses were used to test the association between admission time and in-hospital mortality.ResultsThe average age of the 363 participants in the present study was 52.25 ± 11.77 years, of which 81.6% were male. A total of 183 (50.4%) of these patients were admitted during nighttime. In-hospital mortality rate was higher in the nighttime admission group than in the daytime admission group (HR=1.86; 95%CI, 1.13 to 3.06, P=0.015). After adjusting for age, sex, and other risk factors, nighttime admission suggested as an independent risk factor for in-hospital mortality (HR=2.67, 95%CI, 1.30 to 5.46; P=0.007). Further subgroup analysis showed that none of the variables had a significant effect on the association between nighttime admission and in-hospital mortality.ConclusionNighttime admission for type A acute aortic dissection is associated with a higher risk of in-hospital mortality. Therefore, health care systems should focus on managing the increased risk of in-hospital mortality among patients admitted at night, regardless of the cause. |
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