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Impact of the time elapsed between ICU request and actual admission on mortality and length of stay

Introduction

Measures to ensure an appropriate early treatment for critically ill patients result in significant decreases in mortality [1, 2]. This study aims to evaluate the impact of the time elapsed from request until admission to the ICU on mortality and ICU length of stay (LOS).

Methods

A retrospective cohort study performed on patients in the ICU of Hospital Regional de Samambaia over a period of 4 years, from January 2008 to December 2011. The patients were allocated into two groups: patients who waited longer than 6 hours, long waiting period (LWP, n = 300); and patients whose waiting time was equal to or less than that period, short waiting period (SWP, n = 113).

Results

In total, 413 patients were included, 300 of which belonged to the LWP group (65.4%). For the entire cohort, the mean APACHE II score was 19 ± 7, the mean age was 52 ± 22 years, and 211 patients were male (51.1%). The LWP group did not show difference in the APACHE II score (19 ± 7 vs. 18 ± 8, P = 0.13), but was older (55 ± 20 vs. 49 ± 23, P = 0.01). LWP also had a higher incidence of primary bloodstream infection (23.8% vs. 10.4%, P = 0.01) and catheter-associated urinary tract infection (10.2% vs. 1.9%, P = 0.01). LWP patients had higher mortality (37.8% vs. 25.9%, P = 0.02) and longer ICU LOS (21 ± 47 vs. 14 ± 18 days, P = 0.01). Relative risk for death in the LWP was 1.74 (95% CI: 1.11 to 2.72).

Conclusion

Despite showing no significant differences on APACHE II scores from the SWP group, patients from the LWP group presented greater incidence of primary bloodstream infection, catheter-associated urinary tract infection, higher mortality outcomes and longer ICU LOS.

References

  1. 1.

    Amorim FF, et al.: J Clin Med Res. 2012, 4: 410-414.

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  2. 2.

    Rivers E, et al.: N Engl J Med. 2001, 345: 1368-1377. 10.1056/NEJMoa010307

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Correspondence to GM Filho.

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Filho, G., Silva, T., Santana, A. et al. Impact of the time elapsed between ICU request and actual admission on mortality and length of stay. Crit Care 17, P487 (2013). https://doi.org/10.1186/cc12425

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Keywords

  • Relative Risk
  • High Mortality
  • Early Treatment
  • Retrospective Cohort
  • Retrospective Cohort Study