Related Experiment Video

Updated: Nov 10, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

359

Does admission time matter in a paediatric intensive care unit? A prospective cohort study

Paulo Sérgio Lucas da Silva1, Emerson Yukio Kubo1, Emilio Lopes Junior1

  • 1Department of Pediatrics, Pediatric Intensive Care Unit, Hospital Estadual de Diadema, São Paulo, Brazil.

Journal of Paediatrics and Child Health
|March 31, 2021
PubMed

Insights

Children admitted to the paediatric intensive care unit (PICU) at night have a higher risk of death within 48 hours. This highlights the need to analyze admission times as a quality of care metric.

Area of Science:

  • Pediatric critical care medicine
  • Clinical outcomes research
  • Healthcare quality assessment

Background:

  • Studies on the association between paediatric intensive care unit (PICU) admission time and mortality have yielded conflicting results.
  • Evaluating the impact of admission timing on patient outcomes is crucial for improving care quality.

Purpose of the Study:

  • To investigate the association between the time of admission to a PICU and in-hospital mortality within 48 hours.
  • To determine if admission during night shifts or weekends impacts patient survival rates.

Main Methods:

  • A single-center, prospective cohort study was conducted over 10 years.
  • Data were collected from 1368 consecutive pediatric admissions (1 month to 16 years).
  • Statistical analysis compared mortality rates between daytime and night-time admissions, and weekday and weekend admissions.

Main Results:

  • Overall PICU mortality was 6.6%. Night-time admissions showed significantly higher overall mortality (8.5%) compared to daytime admissions (5.3%).
  • Mortality within 48 hours was also higher for night-time admissions (4.2%) versus daytime (2%).
  • Adjusted odds of death within 48 hours were 2.5 times higher for night-time admissions. No significant difference was found for weekend admissions.

Conclusions:

  • Admission to the PICU during night shifts is strongly associated with an increased risk of death within 48 hours.
  • Admission time should be considered a critical metric for assessing the quality and continuity of care in PICUs.
  • Further research is needed to identify specific factors contributing to this disparity in outcomes.
Abstract

Keywords:
admission timechildrenmortalityoutcomepaediatric intensive care

More Related Videos

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies10:38

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Published on: January 16, 2019

20.5K
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.3K

Related Concept Videos

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
192
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
109
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
82
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
76
Comparing the Survival Analysis of Two or More Groups01:20

Comparing the Survival Analysis of Two or More Groups

Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
387
Assumptions of Survival Analysis01:15

Assumptions of Survival Analysis

Survival models analyze the time until one or more events occur, such as death in biological organisms or failure in mechanical systems. These models are widely used across fields like medicine, biology, engineering, and public health to study time-to-event phenomena. To ensure accurate results, survival analysis relies on key assumptions and careful study design.
237