Circadian aspects of mortality in hospitalized patients: A retrospective observation from a large cohort.
Miao Fang, Shunju Xiang, Xiaoqiang Xiao and 2 others
PMID 36890609WHAT IT FOUND
Among 3300 hospitalized deaths, more occurred daytime than night, with peaks 07:00-12:00 and 15:00-20:00 and lowest 04:00-05:00; sudden cardiac death showed a similar pattern.
Key findings
01More deaths occurred during daytime than at night (54.2% vs 45.8%).
02Deaths peaked between 07:00 and 12:00 and between 15:00 and 20:00, with the lowest incidence from 04:00 to 05:00.
03Sudden cardiac death and non-sudden cardiac death showed similar bimodal daily patterns.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective registry design could introduce biases, including selective bias. Most deceased patients did not have forensic autopsies, so some causes of death could not be confirmed. Results came from one hospital, so they may not apply to other hospitalized populations. Some patients in the non-sudden cardiac death group may have had cardiac causes, which could affect the observed pattern. The study did not test nursing monitoring, staffing, or other interventions, so it cannot show that care changes reduce mortality. Day and night times were not standardized and were defined by a previous report.
Declared interests
None reported.
The easy way to misread this
Do not conclude that increasing nursing monitoring during peak hours will prevent deaths. This was an observational registry of when deaths occurred; it did not test monitoring or any intervention, and it cannot show that changing care at those times changes mortality.