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Emergency physician-based intensive care unit for critically ill patients visiting emergency department.
Am J Emerg Med. 2020 11; 38(11):2277-2282.AJ

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.

Authors+Show Affiliations

Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea. Electronic address: jeonghwain@naver.com.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea. Electronic address: loctos00@gmail.com.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea. Electronic address: suhgil@snu.ac.kr.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea. Electronic address: kwy711@hanmail.net.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea. Electronic address: som0809@naver.com.Department of Emergency Medicine, CHA Bundang Medical Center, Gyeonggi-do 13496, Republic of Korea.Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng

PubMed ID

31785978

Citation

Jeong, Hwain, et al. "Emergency Physician-based Intensive Care Unit for Critically Ill Patients Visiting Emergency Department." The American Journal of Emergency Medicine, vol. 38, no. 11, 2020, pp. 2277-2282.
Jeong H, Jung YS, Suh GJ, et al. Emergency physician-based intensive care unit for critically ill patients visiting emergency department. Am J Emerg Med. 2020;38(11):2277-2282.
Jeong, H., Jung, Y. S., Suh, G. J., Kwon, W. Y., Kim, K. S., Kim, T., Shin, S. M., Kang, M. W., & Lee, M. S. (2020). Emergency physician-based intensive care unit for critically ill patients visiting emergency department. The American Journal of Emergency Medicine, 38(11), 2277-2282. https://doi.org/10.1016/j.ajem.2019.09.021
Jeong H, et al. Emergency Physician-based Intensive Care Unit for Critically Ill Patients Visiting Emergency Department. Am J Emerg Med. 2020;38(11):2277-2282. PubMed PMID: 31785978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency physician-based intensive care unit for critically ill patients visiting emergency department. AU - Jeong,Hwain, AU - Jung,Yoon Sun, AU - Suh,Gil Joon, AU - Kwon,Woon Yong, AU - Kim,Kyung Su, AU - Kim,Taegyun, AU - Shin,So Mi, AU - Kang,Min Woo, AU - Lee,Min Sung, Y1 - 2019/11/16/ PY - 2019/04/11/received PY - 2019/08/11/revised PY - 2019/09/17/accepted PY - 2019/12/2/pubmed PY - 2021/1/22/medline PY - 2019/12/2/entrez KW - Emergency department KW - Emergency medicine KW - Intensive care units KW - Mortality KW - Transfer SP - 2277 EP - 2282 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 38 IS - 11 N2 - 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. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/31785978/Emergency_physician_based_intensive_care_unit_for_critically_ill_patients_visiting_emergency_department_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(19)30605-9 DB - PRIME DP - Unbound Medicine ER -