Background and Goal of Study: Several studies have suggested worse outcomes for patients requiring medical care at night or on weekends. The objectives of this study was to compare technical difficulty of intubation and the incidence of complications of in-hours versus off-hours intubated patients.
Materials and Methods: All intubations performed in our Critical Care Unit during a 23-month period were entered into a prospective collected quality control database. Our main outcomes of interest were compare technical difficulty of intubation, and the incidence of major complications of in-hours versus off-hours intubated patiens. Off-hours intubations included patients who were intubated at nighttime (8.00 PM-7.59 AM) plus weekends/holidays whereas the in-hours intubations included regular daytime weekdays (Monday to Friday: 8:00 AM-7:59 PM).
Results and discussion: Over the 23-month study period (November 2014-September 2016), a total of 219 patients were intubated, of which 107 (48,8%) were intubated during off hours and 112 (51,2%) were intubated in hours. No difference were observed between the two groups in technical difficulty of intubation and in the incidence of major complications. Results are presented in table 1. Recently Ono et al (2) found an association between off hours and airway-related complications in a community emergency department in Japan. They imply the need to improve consistent care during nights and weekends.

Conclusion: In the present study, “off hours” intubations were not associated with an increase in technical difficulty of intubation and in the incidence of major complications. Further studies are required to confirm these findings.

References: (1) Cavallazzi R, Marik PE, Hirani A, el al. Association between time of admission to the ICU ad mortality: a systematic review and metaanalysis. Chest 2010; 138: 68-75(2) Ono Y, Sugiyama T, Chida Y, et al. Association between off-hour presentation and endotracheal-intubation-related adverse events in trauma patients with a predicted difficult airway: a historical cohort study at a community emergency department in Japan. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2016; 24: 106

Are “off hours” intubations a risk factor for complications during intubation?