Survival of critically ill patients hospitalized in and out of intensive care*

Simchen, Elisheva; Sprung, Charles L.; Galai, Noya; Zitser-Gurevich, Yana; Bar-Lavi, Yaron; Levi, Leon; Zveibil, Fabio; Mandel, Micha; Mnatzaganian, George; Goldschmidt, Nethanel; Ekka-Zohar, Anat; Weiss‐Salz, Inbal

doi:10.1097/01.ccm.0000253407.89594.15

Cited by 100 publications

(74 citation statements)

References 29 publications

(22 reference statements)

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“…1 The early period of deterioration may represent a time at which admission to the intensive care unit (ICU) is associated with improved survival, 2 particularly among patients who experience deterioration after admission to the hospital. 3 The existing studies examining the relationship between the delay from onset of clinical deterioration to ICU transfer and mortality were conducted over a decade ago, 4,5 did not examine the role of delays in care escalation, 6 or were restricted to the first 48 h of hospitalization, 7 collectively precluding a contemporary understanding of the impact of such delays throughout a hospital stay.…”

Section: Introductionmentioning

confidence: 99%

“Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients

et al. 2016

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Section: Introductionmentioning

confidence: 99%

“Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients

et al. 2016

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“…[22][23][24] Unfortunately, given the lack of a standardized database in all the units, we were unable to detect a progressive deterioration of clinical condition during the hospital stay. Simchen et al 25 demonstrated that about 2% of all patients admitted to the regular departments of an acute care hospital deteriorate during their hospital stay and reach the criteria of admission to a critical care environment. The majority of these patients (55%) were not, however, transferred early to the ICU or similar environment, so their mortality was likely to increase.…”

Section: Discussionmentioning

confidence: 99%

Influence of the Admission Pattern on the Outcome of Patients Admitted to a Respiratory Intensive Care Unit: Does a Step-Down Admission Differ From a Step-Up One?

Valentini¹,

Pacilli²,

Carbonara³

et al. 2013

Respir Care

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BACKGROUND:The outcomes of patients admitted to a respiratory ICU (RICU) have been evaluated in the past, but no study has considered the influence of location prior to RICU admission. METHODS: We analyzed prospectively collected data from 326 consecutive patients admitted to a 7-bed RICU. The primary end points were survival and severity of morbidity-related complications, evaluated according to the patient's location prior to RICU admission. Three admission pathways were considered: step-down for patients transferred from the ICUs of our hospital; step-up for patients coming from our respiratory wards or other medical wards; and directly for patients coming from the emergency department. The secondary end point was the potential influence of several risk factors for morbidity and mortality. RESULTS: Of the 326 subjects, 92 (28%) died. Overall, subjects admitted in a step-up process had a significantly higher mortality (P < .001) than subjects in the other groups. The mortality rate was 64% for subjects admitted from respiratory ward, 43% for those from medical wards, and 18% for subjects from both ICU and emergency department (respiratory ward vs medical ward P ‫؍‬ .04, respiratory ward vs emergency department P < .001, respiratory ward vs ICU P < .001, medical ward vs emergency department P < .001, and medical ward vs ICU P < .001). Subjects admitted from a respiratory ward had a lower albumin level, and Simplified Acute Physiology Score II was significantly higher in subjects following a step-up admission. About 30% of the subjects admitted from a respiratory ward received noninvasive ventilation as a "ceiling treatment." The highest odds ratios related to survival were subject location prior to RICU admission and female sex. Lack of use of noninvasive ventilation, younger age, female sex, higher albumin level, lower Simplified Acute Physiology Score II, higher Barthel score, and absence of chronic heart failure were also statistically associated with a lower risk of death. CONCLUSIONS: The pathway of admission to a RICU is a determinant of outcome. Patients following a step-up pattern are more likely to die. Other major determinants of survival are age, nutritional status and female sex.

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“…Las camas en las unidades de críticos resultan caras y escasas 2,3 . La admisión en estas unidades estaría restringida a aquellos pacientes que se beneficiarían de sus cuidados, de forma que su excesiva utilización aumentaría de forma innecesaria los costes, mientras que el ser demasiado restrictivos podría llevarnos a un aumento de la mortalidad 3,4 .…”

Section: Introductionunclassified

Análisis de los factores que condicionan el ingreso de los pacientes quirúrgicos en una unidad de críticos. Un estudio prospectivo sobre 764 pacientes intervenidos durante 1 año en un hospital universitario y de referencia

Bona

Bellosta

Cabrera

et al. 2015

Revista Española de Anestesiología y Reanimación

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Survival of critically ill patients hospitalized in and out of intensive care*

Cited by 100 publications

References 29 publications

“Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients

“Deterioration to Door Time”: An Exploratory Analysis of Delays in Escalation of Care for Hospitalized Patients

Influence of the Admission Pattern on the Outcome of Patients Admitted to a Respiratory Intensive Care Unit: Does a Step-Down Admission Differ From a Step-Up One?

Análisis de los factores que condicionan el ingreso de los pacientes quirúrgicos en una unidad de críticos. Un estudio prospectivo sobre 764 pacientes intervenidos durante 1 año en un hospital universitario y de referencia

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