C Weissman1. 1. Department of Anesthesiology and Critical Care Medicine, Hadassah-University Hospital, Jerusalem, Israel. Charles@hadassah.org.il
Abstract
OBJECTIVE: To establish ways of defining long-term ICU patients and to develop methods of quantifying their impact on bed utilization. DESIGN: Retrospective analysis of prospectively collected sample data. SETTING: Two university hospital adult surgical ICUs. PATIENTS: 6,588 consecutive patients admitted over 8 years to ICU 1 and 2,913 patents admitted over 5 years to ICU 2. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Patients with uncommon but expected long stays were designated as long-term patients and those with exceptional and unexpected long stays were designated as outliers. Visualization of the length-of-stay frequency distributions revealed that the "tail" of the distributions began at a stay of about 10 days, and this was chosen as the threshold for long-term patients. A threshold of 30 days was chosen as the outlier threshold since only isolated patients stayed longer. The impact (long-term patients/total admissions) of long-term patients on bed utilization was assessed and year-to-year differences examined. Long-term patients staying at least 10 days used 2.7-5.0 bed-years. CONCLUSIONS: Long-term patients can have a major impact on ICU bed utilization. With 23-45% of the beds occupied by long-term patients, the availability of beds for short-stay patients is reduced. This is important in ICUs where efficient patient throughput is vital, so that beds are availability for both elective and emergency admissions.
OBJECTIVE: To establish ways of defining long-term ICU patients and to develop methods of quantifying their impact on bed utilization. DESIGN: Retrospective analysis of prospectively collected sample data. SETTING: Two university hospital adult surgical ICUs. PATIENTS: 6,588 consecutive patients admitted over 8 years to ICU 1 and 2,913 patents admitted over 5 years to ICU 2. INTERVENTIONS: None. MEASUREMENTS AND RESULTS:Patients with uncommon but expected long stays were designated as long-term patients and those with exceptional and unexpected long stays were designated as outliers. Visualization of the length-of-stay frequency distributions revealed that the "tail" of the distributions began at a stay of about 10 days, and this was chosen as the threshold for long-term patients. A threshold of 30 days was chosen as the outlier threshold since only isolated patients stayed longer. The impact (long-term patients/total admissions) of long-term patients on bed utilization was assessed and year-to-year differences examined. Long-term patients staying at least 10 days used 2.7-5.0 bed-years. CONCLUSIONS: Long-term patients can have a major impact on ICU bed utilization. With 23-45% of the beds occupied by long-term patients, the availability of beds for short-stay patients is reduced. This is important in ICUs where efficient patient throughput is vital, so that beds are availability for both elective and emergency admissions.
Authors: Maurizia Capuzzo; Carlo Volta; Tania Tassinati; Rui Moreno; Andreas Valentin; Bertrand Guidet; Gaetano Iapichino; Claude Martin; Thomas Perneger; Christophe Combescure; Antoine Poncet; Andrew Rhodes Journal: Crit Care Date: 2014-10-09 Impact factor: 9.097
Authors: Anthony J Nastasi; Tyler S Bryant; Jimmy T Le; Jennifer Schrack; Hao Ying; Christine E Haugen; Marlís González Fernández; Dorry L Segev; Mara A McAdams-DeMarco Journal: BMC Geriatr Date: 2018-10-19 Impact factor: 3.921