Association between afterhours admission to the intensive care unit, strained capacity, and mortality: a retrospective cohort study

Table 4 Summary of direct, indirect, and total (integrated) effect of afterhours admission on ICU mortality, hospital mortality, and lengths of stay

Outcome	Direct effect		Indirect effect		Total (integrated effect)
	OR (95% CI)	p value	OR (95% CI)	p value	OR (95% CI)	p value
Mortality
Death in ICU	0.96 (0.87–1.06)	0.39	1.07 (1.05–1.09)	<.0001	1.02 (0.92–1.14)	0.66
Death within 30 h in ICU	1.00 (0.83–1.22)	0.97	1.11 (1.07–1.14)	<.0001	1.11 (0.91–1.35)	0.30
Death within 3 days in ICU	0.97 (0.83–1.14)	0.74	1.09 (1.06–1.12)	<.0001	1.06 (0.91–1.24)	0.46
Death within 7 days in ICU	1.01 (0.88–1.15)	0.94	1.08 (1.06–1.11)	<.0001	1.09 (0.95–1.24)	0.21
Death in hospital	0.94 (0.86–1.03)	0.21	1.05 (1.04–1.07)	<.0001	0.99 (0.91–1.09)	0.89
Length of stay
LOS in ICU	0.93 (0.88–0.98)	0.013	1.02 (1.01–1.02)	<.0001	0.94 (0.89–1.00)	0.0498
LOS in ICU for survivors	0.94 (0.90–0.98)	0.0024	1.03 (1.02–1.04)	<.0001	0.97 (0.93–1.01)	0.11
LOS in ICU for nonsurvivors	1.02 (0.85–1.21)	0.86	0.97 (0.96–0.98)	<.0001	0.98 (0.83–1.17)	0.86
LOS in hospital	0.96 (0.90–1.02)	0.20	1.01 (1.00–1.01)	0.021	0.96 (0.90–1.03)	0.27

OR estimates and their 95% CIs were calculated based on parameter estimates; parameter estimates of integrated effect were based on 1 million times simulation experiments
CI confidence interval, ICU intensive care unit, LOS length of stay, OR odds ratio