Emergency Department to ICU Time Is Associated With Hospital Mortality: A Registry Analysis of 14,788 Patients From Six University Hospitals in The Netherlands*

Groenland, Carline N. L.; Termorshuizen, Fabian; Rietdijk, Wim; Brule, Judith van den; Dongelmans, Dave A.; Jonge, Evert de; Lange, Dylan W. de; Smet, Anne Marie G. A. de; Keizer, Nicolette F. de; Weigel, Joachim; Jewbali, Lucia S.D.; Boersma, Eric; Uil, Corstiaan A. den

doi:10.1097/ccm.0000000000003957

Cited by 62 publications

(41 citation statements)

References 26 publications

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“…When few ICU beds are available, delays in ICU admission hinder timely provision of care leading to worse outcomes [10,11]. The impact of ICU strain on patient outcomes is already well-recognised today [12].…”

Section: Lack Of Icu Beds Is a Problem Right Nowmentioning

confidence: 99%

ICU beds: less is more? No

2020

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Section: Lack Of Icu Beds Is a Problem Right Nowmentioning

confidence: 99%

ICU beds: less is more? No

2020

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“…First, because this study was a single-center retrospective observational study, there is a risk of patient selection bias. Second, we arbitrary defined the long fluoroscopy-time as the longest quintile of the fluoroscopy time, because there were no established cut-off points for the long fluoroscopy time, which were also used in early literatures [31][32][33]. Moreover, if we defined the long fluoroscopy-time as the longest quartile or the longest sextile, the main parameters such as lesion length, tortuosity, and calcification remained significant determinants of the long fluoroscopy time (data was only shown in the peer review process).…”

Section: Study Limitationsmentioning

confidence: 99%

Association of the long fluoroscopy time with factors in contemporary primary percutaneous coronary interventions

et al. 2020

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Background Since the long fluoroscopy time in primary PCI for ST-segment elevation myocardial infarction (STEMI) could be an indicator of delayed reperfusion, it should be important to recognize which types of lesions require longer fluoroscopy-time in primary PCI. The purpose of this study was to investigate the association of the long fluoroscopy-time with clinical factors in primary percutaneous coronary interventions (PCI). Methods A total of 539 patients who underwent primary PCI were divided into the conventional fluoroscopy-time group (Q1-Q4: n = 434) and the long fluoroscopy-time group (Q5: n = 105) according to the quintile of the total fluoroscopy time in primary PCI. Univariate and multivariate logistic regression analyses were performed to find associations between clinical variables and the long fluoroscopy-time. Results In univariate logistic regression analysis, prevalence of diabetes mellitus, hemodialysis, and previous CABG were significantly associated with the long fluoroscopy-time. In addition, complex lesion characteristics such as lesion length, lesion angle, tortuosity, and calcification were associated with the long fluoroscopy-time. In multivariable logistic regression analysis, lesion length [per 10 mm incremental: odds ratio (OR) 1.751, 95% confidence interval (CI) 1.397-2.195, P<0.001], moderate-excessive tortuosity (vs. mild tortuosity: OR 4.006, 95% CI 1.498-10.715, P = 0.006), and moderate to severe calcification (vs. none-mild calcification: OR 1.865, 95% CI 1.107-3.140, P = 0.019) were significantly associated with the long fluoroscopy-time.

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“…Emergency medicine (EM) is the medical specialty that focuses on recognition, evaluation, and coordination of care and treatment of acutely ill patients [ 1 ]. Actualization of a structured emergency department (ED) was achieved by U.S. physicians in the 1960s following the realization that management of acutely ill patients required a dedicated group staffed with specialized physicians [ 2 - 4 ]. Critical care medicine (CCM) is a medical specialty developed to provide advanced monitoring and individualized care to patients facing life-threatening conditions.…”

Section: Introductionmentioning

confidence: 99%

Critical emergency medicine and the resuscitative care unit

et al. 2021

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Critical emergency medicine is the medical field concerned with management of critically ill patients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU) overcrowding has a negative impact on patient care and outcome. It has been proposed that implementation of critical care services in the ED can negate this effect. Two main Critical Emergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU” models. The resource intensivist model is based on constant presence of an intensivist in the traditional ED setting, while the ED-ICU model encompasses the notion of a separate ED-based unit, with monitoring and therapeutic capabilities similar to those of an ICU. Critical emergency medicine has the potential to improve patient care and outcome; however, establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.

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Emergency Department to ICU Time Is Associated With Hospital Mortality: A Registry Analysis of 14,788 Patients From Six University Hospitals in The Netherlands*

Abstract: Supplemental Digital Content is available in the text.

Cited by 62 publications

References 26 publications

ICU beds: less is more? No

ICU beds: less is more? No

Association of the long fluoroscopy time with factors in contemporary primary percutaneous coronary interventions

Critical emergency medicine and the resuscitative care unit

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