Table 1 The main characteristics of the cohort studies included in this meta-analysis
First author/publication year | Study location | Study design | Age (years) | Male (%) | Definition of night or weekend | Disease severity | Population | Adjustments | Outcome | OR and 95% CIs | NOS score | Reference |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Santamaria et al./2015 | 40 ICUs in Australia and New Zealand | Prospective multicenter cohort | Median (IQR) 63 (49–74) | 61 | Night (18:00–06:00) | APACHE III-J risk of death median (IQR) 0.09 (0.03–0.25) | Adult | Markers of illness severity at the time of ICU discharge: age, cardiac surgery, treatment limitation order, tracheostomy, ongoing dialysis, parenteral nutrition, and altered conscious state | In-hospital mortality | 1.16 (0.89, 1.53) | 8 | [15] |
Azevedo et al./2015 | 5 ICUs in Canada | Retrospective multicenter cohort | 57.5 (18.0) | 57.9 | Night (19:00–07:59), weekend (Fri 19:00–Mon 07:59) | APACHE II score 19.4 (7.5) | Adult | Demographics, co-morbidity, APACHE II score at ICU admission, use of mechanical ventilation, ICU length-of-stay, surgical status, admission source, primary diagnostic category, study year, type of hospital | In-hospital mortality | Night 1.29 (1.14, 1.46), weekend 0.95 (0.84, 1.07) | 6 | [31] |
Gantner et al./2014 | 103 ICUs contributing to ANZICS APD from 2005 to 2012 | Retrospective multicenter cohort | After-hours 59.4 (19.8), in-hours 60.3 (19.3) | NA | Night (18:00–06:00) | APACHE III score After-hours 50.0 (25.3), in-hours 46.5 (22.9) | Adult | APACHE III risk of death at ICU admission, presence of treatment limitation orders at ICU admission, diagnostic category, hospital site | In-hospital mortality | 1.34 (1.30, 1.38) | 7 | [30] |
Laupland et al./2011 | French ICUs The Outcomerea database | Retrospective multicenter cohort | Median (IQR) 62 (49–75) | 61 | Night 18:00-07:59) | SAPS II score median (IQR) 40 (28–56) | Adult | Admission SAPSII, medical/surgical classification, presence of septic shock, admission decision to forego life-sustaining therapy(DFLST) order, discharge SOFA score | In-hospital mortality | 1.54 (1.12, 2.11) | 7 | [29] |
Singh et al./2010 | 1 ICU in a tertiary care teaching hospital in Australia | Retrospective single-center cohort | Median 60 | 61.3 | Night (18:00–07:59), weekend (Sat and Sun) | APACHE II score median 18 (range, 1–44) | Adult | Age, APACHE II score at ICU admission, discharge destination | In-hospital mortality | Night 1.38 (1.01, 1.88), weekend 1.04 (0.73, 1.46) | 6 | [10] |
Hanane et al./2008 | 3 ICUs of Mayo Medical Center in USA | Retrospective single-center cohort | Night 61.6 (18.0), day 62.7 (17.8) | Night 56.0, day 53.1 | Night (19:00–06:59) | APACHE III score night 47.6 (21.1), day 44.9 (19.0) | Adult | DNR order by the time of transfer, the last ICU day APACHE III predicted mortality | In-hospital mortality | 1.05 (0.64, 1.70) | 7 | [13] |
Laupland et al./2008 | 4 ICUs in the Calgary Health Region, Alberta, Canada | Retrospective single-center cohort | Median (IQR) 63.7 (49.9–73.8) | 64 | Night (18:00–07:59), weekend (Sat and Sun) | APACHE II score 25.1 (8.48) | Adult | Noncardiac surgery, cardiac surgery, age, APACHE II at ICU admission, weekend admission, night admission, regional resident | In-hospital mortality | Weekday night discharge 1.20 (1.01, 1.41), weekend day discharge 0.81 (0.67, 0.98), weekend night discharge 1.35 (1.05, 1.73) | 6 | [12] |
Pilcher et al./2007 | 40 ICUs in Australia and New Zealand | Retrospective multicenter cohort | Night 58.6 (0.08), day: 59.1 (0.17) | NA | Night (18:00–06:00) | APACHE III score night 47.7 (0.2), day: 46.0 (0.1) | Adult | APACHE III risk of death at admission, emergency admission to ICU | In-hospital mortality | 1.42 (1.32, 1.53) | 6 | [9] |
Tobin et al./2006 | 1 ICU in Australia | Retrospective single-center cohort | 64 (13–98) | 65 | Night (22:00–06:59), weekend (Fri 18:00–Mon 07:59) | APACHE II score median 13 (range 0–53) | Adult | Age, APACHE II score at admission, origin of admission, treatment category | In-hospital mortality | Night 1.63 (1.03, 2.57), weekend 1.46 (1.18, 1.81) | 6 | [8] |
Priestap et al./2006 | 31 Critical care units across Canada | Retrospective multicenter cohort | Night 61.6 (17.7), day 61.7 (17.5) | Night 58, day 57.4 | Night (21:00–06:59) | APACHE II score night 15.7 (7.7), day 15.0 (7.4) | Adult | Differences in illness severity at admission, gender, age, admission source, admission diagnosis, site | In-hospital mortality | 1.22 (1.10, 1.36) | 6 | [11] |
Duke et al./2004 | 1 ICU in the Northern Hospital in Australia | Prospective single-center cohort | Median (IQR) 62 (42–73) | NA | Night (22:00–07:30) | APACHE II score 15 (10–21) | Adult | age, APACHE II predicted mortality at admission, premature discharge, delayed discharge, limitation of medical treatment decision, emergency admission, mechanical ventilation, APACHE II diagnosis, chronic health status categories | In-hospital mortality | 1.7 (1.03, 2.9) | 7 | [7] |
Uusaro et al./2003 | 18 ICUs in university and central hospitals in Finland | Retrospective multicenter cohort | NA | NA | Night (16:00–08:00), weekend (Fri 16:00–Sun 24:00) | SAPS II score 34 (17) | Adult | Disease severity at ICU admission, intensity of care, and whether restrictions for future care were set | In-hospital mortality | Night 1.11 (0.93, 1.31), weekend 0.88 (0.73, 1.07) | 7 | [14] |
Beck et al./2002 | 9 ICUs in a district general hospital in United Kingdom | Retrospective single-center cohort | 57 (19) | 61.7 | Night (20:00–07:59) | APACHE II probabilities 18.3 (18.7) | Adult | Disease severity at ICU admission | In-hospital mortality | 1.70 (1.28, 2.25) | 6 | [6] |
Goldfrad et al./2000 | 88 ICUs in the United Kingdom | Retrospective multicenter cohort | Mean (95% CI) night 57.5 (56.4–58.7), day 58.2 (57.9–58.5) | NA | Night (22:00–06:59) | APACHE II score mean (95% CI), night 15.5 (15.1–16.0), day 14.6 (14.5–14.7) | Adult | Case-mix (age, medical history, acute severity), premature discharge | In-hospital mortality | 1.17 (0.92, 1.49) | 6 | [5] |