Otavio T Ranzani1, Fernando Godinho Zampieri2, Leandro Utino Taniguchi3, Daniel Neves Forte3, Luciano César Pontes Azevedo3, Marcelo Park3. 1. Intensive Care Unit, Emergency Medicine Discipline, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. Electronic address: otavioranzani@yahoo.com.br. 2. Intensive Care Unit, Emergency Medicine Discipline, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil; Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil. 3. Intensive Care Unit, Emergency Medicine Discipline, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil; Research and Education Institute, Hospital Sírio-Libanês, São Paulo, Brazil.
Abstract
PURPOSE: The impact of the intermediate care unit (IMCU) on post-intensive care unit (ICU) outcomes is controversial. MATERIALS AND METHODS: We analyzed admissions from January 2003 to December 2008 from a mixed ICU in a teaching hospital in Brazil with a high patient-to-nurse ratio (3.5:1 on the ICU, 11:1 on the IMCU, 20-25:1 on the ward). A retrospective propensity-matched analysis was performed with data from 690 patients who were discharged after at least 3 days of ICU stay. RESULTS: Of the 690 patients, 160 (23%) were discharged to the IMCU. A total of 399 propensity-matched patients were compared: 298 were discharged to the ward and 101 were discharged to the IMCU. Ninety-day mortality rate was similar between the IMCU and ward patients (22% vs 18%, respectively, P = .37), as was the unplanned ICU readmission rate (P = .63). In a multivariate logistic regression, discharge to the IMCU had no effect on the 90-day mortality rate (P = .27). CONCLUSIONS: In a resource-limited setting with a high patient-to-nurse ratio, discharge to IMCU had no impact on 90-day mortality rate and on unplanned readmission rate. The impact of discharge to the IMCU on the outcome for critically ill patients should be evaluated in further studies.
PURPOSE: The impact of the intermediate care unit (IMCU) on post-intensive care unit (ICU) outcomes is controversial. MATERIALS AND METHODS: We analyzed admissions from January 2003 to December 2008 from a mixed ICU in a teaching hospital in Brazil with a high patient-to-nurse ratio (3.5:1 on the ICU, 11:1 on the IMCU, 20-25:1 on the ward). A retrospective propensity-matched analysis was performed with data from 690 patients who were discharged after at least 3 days of ICU stay. RESULTS: Of the 690 patients, 160 (23%) were discharged to the IMCU. A total of 399 propensity-matched patients were compared: 298 were discharged to the ward and 101 were discharged to the IMCU. Ninety-day mortality rate was similar between the IMCU and ward patients (22% vs 18%, respectively, P = .37), as was the unplanned ICU readmission rate (P = .63). In a multivariate logistic regression, discharge to the IMCU had no effect on the 90-day mortality rate (P = .27). CONCLUSIONS: In a resource-limited setting with a high patient-to-nurse ratio, discharge to IMCU had no impact on 90-day mortality rate and on unplanned readmission rate. The impact of discharge to the IMCU on the outcome for critically illpatients should be evaluated in further studies.
Authors: Michael W Sjoding; Thomas S Valley; Hallie C Prescott; Hannah Wunsch; Theodore J Iwashyna; Colin R Cooke Journal: Am J Respir Crit Care Med Date: 2016-01-15 Impact factor: 21.405
Authors: Rebeccah M Brusca; Catherine E Simpson; Sarina K Sahetya; Zeba Noorain; Varshitha Tanykonda; R Scott Stephens; Dale M Needham; David N Hager Journal: J Intensive Care Med Date: 2019-10-21 Impact factor: 3.510
Authors: Otavio T Ranzani; Fernando G Zampieri; Bruno A M P Besen; Luciano C P Azevedo; Marcelo Park Journal: Crit Care Date: 2015-06-25 Impact factor: 9.097
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: Cinthia Mendes Rodrigues; Ellen Maria Campos Pires; Jorge Patrick Oliveira Feliciano; Jose Mauro Vieira; Leandro Utino Taniguchi Journal: Rev Bras Ter Intensiva Date: 2016 Jan-Mar
Authors: Donna Lee Armaignac; Anshul Saxena; Muni Rubens; Carlos A Valle; Lisa-Mae S Williams; Emir Veledar; Louis T Gidel Journal: Crit Care Med Date: 2018-05 Impact factor: 7.598