Emergency physician-based intensive care unit for critically ill patients visiting emergency department

Hwain Jeong, Yoon Sun Jung, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, So Mi Shin, Min Woo Kang, Min Sung Lee

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: To provide a prompt and optimal intensive care to critically ill patients visiting our emergency department (ED), we set up and ran a specific type of emergency intensive care unit (EICU) managed by emergency physician (EP) intensivists. We investigated whether this EICU reduced the time interval from ED arrival to ICU transfer (ED-ICU interval) without altering mortality. Methods: This was a retrospective study conducted in a tertiary referral hospital. We collected data from ED patients who were admitted to the EICU (EICU group) and other ICUs including medical, surgical, and cardiopulmonary ICUs (other ICUs group), from August 2014 to July 2017. We compared these two groups with respect to demographic findings, including the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, ED-ICU interval, ICU mortality, and hospital mortality. Results: Among the 3440 critically ill patients who visited ED, 1815 (52.8%) were admitted to the EICU during the study period. The ED-ICU interval for the EICU group was significantly shorter than that for the other ICUs group by 27.5% (5.0 ± 4.9 vs. 6.9 ± 5.4 h, p < 0.001). In multivariable analysis, the ICU mortality (odds ratio = 1.062, 95% confidence interval 0.862–1.308, p = 0.571) and hospital mortality (odds ratio = 1.093, 95% confidence interval 0.892–1.338, p = 0.391) of the EICU group were not inferior to those of the other ICUs group. Conclusions: The EICU run by EP intensivists reduced the time interval from ED arrival to ICU transfer without altering hospital mortality.

Original languageEnglish
Pages (from-to)2277-2282
Number of pages6
JournalAmerican Journal of Emergency Medicine
Volume38
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Emergency department
  • Emergency medicine
  • Intensive care units
  • Mortality
  • Transfer

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