Why the study?
Demographics in CICUs have evolved with increased noncardiac critical illnesses, prompting a comparison of outcomes for patients with primary cardiac diagnoses admitted to CICUs versus noncardiac ICUs.
Does admission to a Cardiac Intensive Care Unit (CICU) reduce inpatient mortality in adults with primary cardiac diagnoses compared to admission to a noncardiac ICU?
Does admission to a Cardiac Intensive Care Unit (CICU) reduce inpatient mortality in adults with primary cardiac diagnoses compared to admission to a noncardiac ICU?
Survival of cardiac patients with concurrent noncardiac critical illnesses may have been better in general ICUs, supporting contemporary efforts to increase the capacity to manage noncardiac critical illnesses in CICUs.
May favor general ICU for cardiac patients with noncardiac illness; supports expanding CICU noncardiac capabilities.
BACKGROUND: Demographics in cardiac intensive care units (CICUs) have evolved, with increased prevalence of noncardiac critical illnesses. OBJECTIVES: This study compares outcomes of patients with primary cardiac diagnoses admitted to CICUs vs those of patients with primary cardiac diagnoses admitted to noncardiac ICUs. METHODS: The Cerner Health Facts Database was queried to identify adults with primary cardiac diagnoses admitted to ICUs within 48 hours of presentation between 2009 and 2014. Only hospitals with multiple ICUs including a CICU were studied. Information on ICU staffing was not available. A univariate analysis of ICU type (model 1) and multivariate analyses incorporating patient- and hospital-level variables (model 2) and concurrent, noncardiac, ICU-level diagnoses (model 3) were utilized to assess the impact of ICU type on inpatient mortality. RESULTS: = 0.03). CONCLUSIONS: In this historical cohort study evaluating CICU outcomes prior to the evolution of proposed staffing and care model modernization, survival of cardiac patients with concurrent, noncardiac critical illnesses may have been better with the expertise available in general system ICUs. These results may support contemporary efforts to increase the capacity to manage noncardiac critical illnesses in CICUs.
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Brusca et al. (2022) studied this question.
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