One more idea on preventable ICU deaths ...

  • Jan JM Ligtenberg1Email author,

    Affiliated with

    • Bas W Bens1 and

      Affiliated with

      • Jack C ter Maaten1

        Affiliated with

        Critical Care201216:438

        DOI: 10.1186/cc11371

        Published: 6 July 2012

        In recent issues of Critical Care two papers regarding ICU mortality caught our eye: an interesting viewpoint article on preventable mortality by Dijkema and colleagues [1], and a research paper on the impact of ICU admission during morning rounds on mortality by de Souza and colleagues [2]. It appeared to us that an important factor to avoid preventable ICU deaths is not mentioned: the time period before the critically ill patient is finally admitted to the ICU.

        As we know, early recognition of deteriorating patients in the nursing ward and in the emergency department followed by subsequent resuscitation treatment saves lives. The ICU patient admitted during morning rounds is usually already staying on the ward and has been deteriorating during the night: admission to the ICU might have been delayed during the night shift, resulting in a higher ICU mortality [2, 3]. The same situation applies to patients admitted from the emergency department, who are treated according to the appropriate protocols but - for logistic or other reasons - may have to wait for their necessary admission to the ICU in an environment that may be less suitable after the first acute treatment and stabilization.

        In our university-hospital-based emergency department with 34,000 patients/year, 579 patients were admitted to the ICU in 2011: the average time spent in the emergency department was 3 hours and 4 minutes. We think it might be useful to include measures to shorten the time period prior to ICU admission in the evaluation of preventable ICU deaths.

        Declarations

        Authors’ Affiliations

        (1)
        Emergency Department, University Medical Center Groningen

        References

        1. Dijkema LM, Dieperink W, van Meurs M, Zijlstra JG: Preventable mortality evaluation in the ICU. Crit Care 2012, 16:309.PubMedView Article
        2. de Souza IA, Karvellas CJ, Gibney RN, Bagshaw SM: Impact of intensive care unit admission during morning bedside rounds and mortality: a multicenter retrospective cohort study. Crit Care 2012, 16:R72.PubMedView Article
        3. Afessa B, Gajic O, Morales IJ, Keegan MT, Peters SG, Hubmayr RD: Association between ICU admission during morning rounds and mortality. Chest 2009, 136:1489–1495.PubMedView Article

        Copyright

        © BioMed Central Ltd 2012

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