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January 20, 2020Clinical Medicine & ResearchOpen Access

Mortality of Patients Requiring Escalation to Intensive Care within 24 Hours of Admission in a Mixed Medical-Surgical Population

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Key result

Escalation to the ICU within 24 hours of hospital admission was associated with significantly increased 1-year mortality in surgical patients, but not in medical patients.

Why the study?

Delayed ICU admissions are associated with increased mortality, but whether indirect ICU admissions within 24 hours of hospital admission are associated with increased mortality required evaluation.

Does escalation to the ICU within 24 hours of hospital admission increase mortality in a mixed medical-surgical population?

Population

3,862 mixed medical and surgical ICU admissions at a tertiary VA Hospital System

Comparison

Indirect admission within 24 hours vs direct ICU admission

Design

Retrospective cohort study

Follow-up

1-year

Authors

JLJason LeongJMJai MadhokGLGeoffrey K. Lighthall

Discussion

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Member takes

Overview

Early ICU escalation signals higher 1-year mortality in surgical patients; observational findings leave causality and intervention effects open for prospective study.

Study Design

Type

Cohort (n=3,862)

Multicenter

No

Structured PICO

Does escalation to the ICU within 24 hours of hospital admission increase mortality in a mixed medical-surgical population?

P
Population
3,862 mixed medical and surgical patients admitted to a VA medical-surgical ICU between 2008 and 2013, evaluated for 1-year mortality.
E
Exposure
Escalation to the ICU after initial admission to the ward (indirect admission) within 24 hours of hospital admission.
C
Comparator
Direct admission to the ICU (e.g., directly from the operating room).
O
Outcome
1-year mortalityhard clinical

Escalation to the ICU within 24 hours of ward admission is associated with increased 1-year mortality in surgical patients, but not in medical patients.

Limitations

  • Lack of effect in medical patients possibly related to a burden of illness that could not be altered by earlier care.

Cite This Study

Leong et al. (2020) conducted a cohort in Mixed medical-surgical ICU admissions (n=3,862). Escalation to the ICU within 24 hours of hospital admission vs. Direct admission to the ICU was evaluated on 1-year mortality. Escalation to the ICU within 24 hours of hospital admission was associated with significantly increased 1-year mortality in surgical patients, but not in medical patients.

synapsesocial.com/papers/6a1eccb0bf2a5d44faaf5647https://doi.org/10.3121/cmr.2019.1497
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Also Consider

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