Abstract
Introduction
Unplanned Intensive Care Unit (ICU) admission has been used as a surrogate marker
of adverse events, and is used by the Australian Council of Healthcare Accreditation
as a reportable quality indicator. If we can identify independent variables predicting
deterioration which require ICU transfer within 24 h after emergency department (ED) admission, direct ICU admission should be considered.
This may improve patient safety and reduce adverse events by appropriate disposition
of patients presenting to the ED.
Objective(s)
The aim of this study was to identify independent variables predicting deterioration
which require ICU transfer within 24 h after ED admission.
Methods
A case control study was performed to examine characteristics of patients who underwent
an unplanned transfer to the ICU within 24 h after ED admission.
Results
There were significantly more hypercapnia patients in the ICU admission group (n = 17) compared to the non-ICU group (n = 5) (p = 0.028). There were significantly greater rates of tachypnea in septic patients (p = 0.022) and low oxygen saturation for patients with pneumonia (p = 0.045). The level of documentation of respiratory rate was poor.
Conclusions
In patients presenting to the ED, hypercapnia was a predictor for deterioration which
requires ICU transfer within 24 h after ED admission. Additional predicting factors in patients with sepsis or pneumonia
were respectively tachypnea and low oxygen saturation. For these patient groups direct
ICU admission should be considered to prevent unplanned ICU admission. This data emphasizes
the importance of measuring the vital signs, particularly the respiratory rate.
Keywords
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Article Info
Publication History
Published online: March 12, 2017
Accepted:
March 10,
2017
Received in revised form:
March 9,
2017
Received:
October 5,
2016
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
