Increased Inpatient Length of Stay After Early Unplanned Transfer to Higher Levels of Care.
emergency department admission
inpatient length of stay
intermediate care unit
medical-surgical unit
transfer of care
triage
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
entrez:
20
5
2020
pubmed:
20
5
2020
medline:
20
5
2020
Statut:
epublish
Résumé
Patients admitted to a medical-surgical unit infrequently require early transfer to higher level care, although how their inpatient length of stay compares to untransferred patients, or those directly admitted to intermediate care, is unknown. We sought to compare the inpatient length of stay of these groups. Single-site retrospective analysis. An academic hospital specializing in complex care. We evaluated 23,694 patients admitted to the Hospital Internal Medicine service over a 4-year period (January 1, 2013, to December 31, 2016). None. Using 6- and 24-hour definitions of early transfer, we categorized patients as admitted to medical-surgical unit without early transfer (medical-surgical unit), transferred (TX) early to higher level care, or initially admitted to an intermediate care unit. We report patient characteristics and inpatient length of stay adjusted for patient demographics (age and sex) and initial acuity (measured by Emergency Severity Index). There were significant increases in both unadjusted inpatient length of stay (6 hr: medical-surgical unit = 73.4 hr, TX = 137.9 hr, intermediate care unit = 101.1 hr; 24 hr: medical-surgical unit = 72.4 hr, TX = 141.9 hr, intermediate care unit = 98.2 hr; In a single facility study, patients admitted to a medical/surgical unit who require early transfer to intermediate care unit have a significant and unexplained increase in inpatient length of stay. This unexplained increased inpatient length of stay suggests that triage to the appropriate inpatient unit significantly affects inpatient length of stay.
Identifiants
pubmed: 32426745
doi: 10.1097/CCE.0000000000000103
pmc: PMC7188428
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0103Informations de copyright
Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Déclaration de conflit d'intérêts
The authors have disclosed that they do not have any potential conflicts of interest.
Références
J Hosp Med. 2012 Mar;7(3):224-30
pubmed: 22038879
Chest. 1991 Mar;99(3):685-9
pubmed: 1995226
BMJ. 1998 Jun 20;316(7148):1853-8
pubmed: 9632403
Chest. 1993 Sep;104(3):876-81
pubmed: 8365304
Chest. 1998 Jan;113(1):172-7
pubmed: 9440586
Anaesthesia. 2008 Jul;63(7):695-700
pubmed: 18489613
J Gen Intern Med. 2003 Feb;18(2):77-83
pubmed: 12542581
Crit Care Med. 1993 Oct;21(10):1547-53
pubmed: 8403966
BMJ Open. 2014 Nov 27;4(11):e005553
pubmed: 25431221
Anaesthesia. 1998 Jul;53(7):654-64
pubmed: 9771174
Crit Care Med. 2007 Jun;35(6):1477-83
pubmed: 17440421
Crit Care Med. 1998 Mar;26(3):607-10
pubmed: 9504593
Chest. 1995 Aug;108(2):490-9
pubmed: 7634889
Crit Care. 2006;10(3):R81
pubmed: 16749940
JAMA. 1981 Apr 10;245(14):1446-9
pubmed: 7206147
Crit Care Med. 1990 Nov;18(11):1231-5
pubmed: 2225891
Crit Care Med. 2009 Nov;37(11):2867-74
pubmed: 19770748
Arch Intern Med. 1988 Jun;148(6):1403-5
pubmed: 3132123
Am J Crit Care. 2016 Dec;26(1):e1-e10
pubmed: 27965236
Crit Care. 2014 Oct 09;18(5):551
pubmed: 25664865
J Hosp Med. 2016 Nov;11(11):757-762
pubmed: 27352032
J Hosp Med. 2011 Feb;6(2):74-80
pubmed: 21290579