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Factors related to delayed intensive care unit admission from Emergency Department: A retrospective cohort study

Acta Anaesthesiologica Scandinavica Mar 24, 2019

Aitavaara-Anttila M, et al. - Researchers examined 479 adult patients admitted from the emergency department (ED) to the intensive care unit (ICU) between May 31, 2016, and March 19, 2017, in Oulu University Hospital in order to determine ED-related factors associated with prolonged ED stay. Delayed length of stay (LOS) was defined as a patient's ED LOS > 180 minutes. For ED LOS > 180 minutes, the odds ratios (ORs) in a logistic regression analysis were 2.73 for Glasgow Coma Scale score > 9, 6.69 for thrombocytes < 100 × 109/mmol, 5.27 for absence of pre-arrival notification, and 3.95 for radiological examination. Shorter ED LOS was observed among trauma and intoxicated patients while, more often, prolonged admissions were reported among patients with medical conditions. Findings revealed an association of delays in ICU admissions, with therapeutic and diagnostic procedures and absence of pre-arrival notification. Based on diagnosis, patients were admitted to the ICU, rather than based on clinical risk. However, no link was found between delays and worsening outcome, which suggested that sufficient care could be offered at the ED while the ICU admission was pending.

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