From the Coronary Care Unit to the Cardiovascular Intensive Care Unit

Gidwani, Umesh; Kini, Annapoorna

doi:10.1016/j.ccl.2013.07.012

Cited by 9 publications

(9 citation statements)

References 27 publications

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“…Paradoxically as medicine has become more specialised we have seen the development of a coherent evidence base for treatment of organ specific illnesses such as stroke, heart disease and chronic obstructive airways disease. [21][22][23] Efforts are made by institutions to implement these changes and it can be seen as a failure of standards if patients are not able to benefit from these structured systems that have been shown to optimise the patient journey and enhance outcomes.…”

Section: Discussionmentioning

confidence: 99%

Does admission via an Acute Medical Unit influence hospital mortality? 12 years’ experience in a large Dublin Hospital

Coary¹,

Byrne²,

O’Riordan³

et al. 2014

Acute Med

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Background: Following an emergency medical admission, patients may be admitted an acute medical assessment unit (AMAU) or directly into a ward. An AMAU provides a structured environment for their initial assessment and treatment. Methods: All emergency admissions (66,933 episodes in 36,271 patients) to an Irish hospital over an 12-year period (2002-2013) were studied with 30-day in-hospital mortality as the outcome measure. Univariate Odds Ratios, by initial patient allocation, and the fully adjusted Odds Ratios were calculated, using a validated logistic regression model. Results: Patients, by design, were intended to be admitted initially to the AMAU (<= 5 day stay). Capacity constraints dictated that only 39.8% of patients were so admitted; the remainder bypassed the AMAU to a ward (60.2%). All patients remained under the care of the admitting consultant/team. We computed the risk profile for each group, using a multiple variable validated model of 30-day in-hospital mortality; the model indicated the same risk profile between these groups. The univariate OR of an in-hospital death by day 30 for a patient initially allocated to the AMAU, compared with an initial ward allocation was 0.76 (95% CI: 0.71, 0.82- p<0.001). The fully adjusted risk for patients was 0.67 (95% CI: 0.62, 0.73- p<0.001). Conclusion: Patients, with equivalent mortality risk, allocated initially to AMAU or a more traditional ward, appeared to have substantially different outcomes.

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Section: Discussionmentioning

confidence: 99%

Does admission via an Acute Medical Unit influence hospital mortality? 12 years’ experience in a large Dublin Hospital

Coary¹,

Byrne²,

O’Riordan³

et al. 2014

Acute Med

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“…Nevertheless, the rates of coronary angiography, PCI, and CABG were similar in both groups. ICCUs are no longer reserved solely for ACS patients [10,11]. As life expectancy increases and populations become older, Western medicine faces new challenges.…”

Section: Discussionmentioning

confidence: 99%

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

Mazin

Matetzky²,

Shemer³

et al. 2017

Cardiology

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Objectives: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). Methods: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015. Patients with malignancies (n = 256) were divided into 2 groups: those with solid and those with homogenous tumors. Results: The time of diagnosis was categorized into 3 patient groups: recent (<6 months), 59 patients (23%); late (6-24 months), 49 patients (19%), and very late (>24 months), 148 patients (58%). Those with a history of malignancy were older (73 ± 12 vs. 64 ± 15, p < 0.001) and were more likely to be female (p = 0.002). After using a multivariate logistic regression model analysis, no differences were found in therapeutic interventions and clinical outcomes, including major bleeding and acute renal failure, between patients with and without malignancies. Conclusions: Patients with a malignancy comprised about 10% of the entire ICCU population. While mortality was independently associated with advanced age, renal failure, and a diagnosis of ST-elevation myocardial infarction, malignancy alone was not found to be independently associated with a higher mortality rate at 30 days of follow-up.

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“…Even in cardiovascular diseases, many cases are complicated by multiple organ failure, and elderly heart failure is increased. ICU has been changed from the CCU to advanced cardiac intensive care unit [3], cardiovascular intensive care unit [8,44,45], or intensive cardiac care unit [[ 2 _ T D $ D I F F ] 46], which deal with cardiovascular diseases and respond to multiple organ failure management by multiple medical teams including various field physicians. In such circumstances, several scores for predicting the outcome of severe cases have been proposed and shifting to lifesaving for more severe cases in ICU.…”

Section: Severity Scores For Cardiovascular Diseases In Cicumentioning

confidence: 99%

The necessity of conversion from coronary care unit to the cardiovascular intensive care unit required for cardiologists

Nonogi

2019

Journal of Cardiology

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From the Coronary Care Unit to the Cardiovascular Intensive Care Unit

Cited by 9 publications

References 27 publications

Does admission via an Acute Medical Unit influence hospital mortality? 12 years’ experience in a large Dublin Hospital

Does admission via an Acute Medical Unit influence hospital mortality? 12 years’ experience in a large Dublin Hospital

The “Burden” of Malignancy in a Tertiary Hospital Intensive Cardiovascular Care Unit

The necessity of conversion from coronary care unit to the cardiovascular intensive care unit required for cardiologists

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