The Effect of an Intermediate Care Unit on the Demographics and Outcomes of a Surgical Intensive Care Unit Population

The Impact of the Organization of High-Dependency Care on Acute Hospital Mortality and Patient Flow for Critically Ill Patients

“…Despite the high mortality for critically ill patients and the expense of critical care services, few data exist on the impact of different organizational models for provision of such care (3). In particular, few studies have addressed the impact on patient flow and outcome of the provision of HDC, either integrated with IC or in a separate unit (4)(5)(6)(7). With recognition that transitions of care out of IC may be a period of risk for patients (8), the physical location and flexibility of beds becomes important.…”

“…The total duration of critical care (summing days in both the primary unit and the geographically separate unit, where relevant) was longer for patients cared for in primary units with dual HDC (median, 7 [4][5][6][7][8][9][10][11][12][13] vs. 6 [3][4][5][6][7][8][9][10][11] d; adjusted relative difference, 1.09 [1.03-1.16]; P = 0.002). Total acute hospital length of stay did not differ, nor did estimates of the overall costs of critical care, after risk-adjustment (Table 4).…”

Caution when using prognostic models: A prospective comparison of 3 recent prognostic models

“…Even small differences in case mix have been shown to influence the score's calibration [24]. Another important difference is that we studied a predominantly low-risk population, a fact that may be related to the absence of intermediate care units in the 3 hospitals [25]. In our cohort, 73% of the patients had a predicted risk of death of less than 10% for APACHE IV, 52% for SAPS 3, and 60% for MPM 0 -III.…”

Triage of Intermediate-Care Patients in Pediatric Hospitals

“…This is in keeping with data from adult literature that support the role of the IMCU in improving ICU utilization for sicker patients. [9][10][11][12] In particular, Byrick et al 13,14 described the impact of closure of an IMCU in 1 hospital, resulting in a fourfold increase in ICU admissions with a lower severity of illness. More recent literature describes successful care for adult patients with specific diseases in IMCUs, including severe asthma and sepsis.…”