Associations of day of week and time of day of ICU admission with hospital mortality in Malawi

This prospective cohort study evaluated the associations of day and time of admission to the Intensive Care Unit (ICU) with hospital mortality at a referral hospital in Malawi, a low-income country in sub-Saharan Africa. Patients admitted to the ICU during the day (08:00-16:00) were compared to those admitted at night (16:01-07:59); patients admitted on weekdays (Monday-Friday) were compared to admissions on weekends/holidays. The primary outcome was hospital mortality. Most patients were admitted during daytime (56%) and on weekdays (72%). There was no difference in mortality between night and day admissions (58% vs. 56%,P = 0.8828; hazard ratio [HR] = 1.09, 95% confidence interval [CI = 0.82-1.44,P = 0.5614) or weekend/holiday versus weekday admissions (56% vs. 57%,P = 0.9011; HR = 0.87, 95% CI = 0.62-1.21,P = 0.4133). No interaction between time and day was found. These results may be affected by high overall hospital mortality.