Tags

Type your tag names separated by a space and hit enter

A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation.
J Crit Care. 2017 12; 42:123-128.JC

Abstract

PURPOSE

To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes.

MATERIALS AND METHODS

Retrospective cohort study at a tertiary hospital comparing two 12-month periods before and after implementation of a 'Code ICU' system of expedited review of critically ill patients in the ED. All adult ED to ICU admissions were included. Separate analyses were performed for patients intubated prior to ICU admission.

RESULTS

622 and 629 patients were included in each time period. During the intervention period more patients had ED LOS<240min in both the total [199 (32.0%) vs. 243 (38.6%), P=0.014; adjusted OR 1.60, 95% CI 1.14-2.25] and intubated cohorts [145 (51.2%) vs. 172 (61.9%), P=0.011; adjusted OR 1.65, 95% CI 1.16-2.36]. 'Code ICU' intubated patients had a shorter duration of mechanical ventilation, ICU LOS and hospital LOS compared to non-'Code ICU' intubated patients.

CONCLUSIONS

A system of rapid review of critically ill patients in the ED was associated with reduced ED LOS and improved ICU outcomes.

Authors+Show Affiliations

Intensive Care Unit, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia. Electronic address: matthew.durie@mh.org.au.Intensive Care Unit, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia; Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia. Electronic address: jai.darvall@mh.org.au.Intensive Care Unit, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia.Melbourne EpiCentre, Royal Melbourne Hospital, Grattan St, Parkville, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, Victoria, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28723586

Citation

Durie, Matthew L., et al. "A "Code ICU" Expedited Review of Critically Ill Patients Is Associated With Reduced Emergency Department Length of Stay and Duration of Mechanical Ventilation." Journal of Critical Care, vol. 42, 2017, pp. 123-128.
Durie ML, Darvall JN, Hadley DA, et al. A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation. J Crit Care. 2017;42:123-128.
Durie, M. L., Darvall, J. N., Hadley, D. A., & Tacey, M. A. (2017). A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation. Journal of Critical Care, 42, 123-128. https://doi.org/10.1016/j.jcrc.2017.07.011
Durie ML, et al. A "Code ICU" Expedited Review of Critically Ill Patients Is Associated With Reduced Emergency Department Length of Stay and Duration of Mechanical Ventilation. J Crit Care. 2017;42:123-128. PubMed PMID: 28723586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation. AU - Durie,Matthew L, AU - Darvall,Jai N, AU - Hadley,Daniel A, AU - Tacey,Mark A, Y1 - 2017/07/06/ PY - 2017/03/19/received PY - 2017/05/30/revised PY - 2017/07/03/accepted PY - 2017/7/21/pubmed PY - 2018/7/3/medline PY - 2017/7/21/entrez KW - Emergency service, hospital KW - Hospital referral KW - Intensive care units KW - Length of stay KW - Mechanical ventilation KW - Patient transfer SP - 123 EP - 128 JF - Journal of critical care JO - J Crit Care VL - 42 N2 - PURPOSE: To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes. MATERIALS AND METHODS: Retrospective cohort study at a tertiary hospital comparing two 12-month periods before and after implementation of a 'Code ICU' system of expedited review of critically ill patients in the ED. All adult ED to ICU admissions were included. Separate analyses were performed for patients intubated prior to ICU admission. RESULTS: 622 and 629 patients were included in each time period. During the intervention period more patients had ED LOS<240min in both the total [199 (32.0%) vs. 243 (38.6%), P=0.014; adjusted OR 1.60, 95% CI 1.14-2.25] and intubated cohorts [145 (51.2%) vs. 172 (61.9%), P=0.011; adjusted OR 1.65, 95% CI 1.16-2.36]. 'Code ICU' intubated patients had a shorter duration of mechanical ventilation, ICU LOS and hospital LOS compared to non-'Code ICU' intubated patients. CONCLUSIONS: A system of rapid review of critically ill patients in the ED was associated with reduced ED LOS and improved ICU outcomes. SN - 1557-8615 UR - https://www.unboundmedicine.com/medline/citation/28723586/A_"Code_ICU"_expedited_review_of_critically_ill_patients_is_associated_with_reduced_emergency_department_length_of_stay_and_duration_of_mechanical_ventilation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0883-9441(17)30312-X DB - PRIME DP - Unbound Medicine ER -