Skip to main content

Differences in severity and resource utilization for medical and surgical ICU patients

Introduction

Medical and surgical patients use the ICU differently. Resources may not always be allocated by severity of illness, but by custom or habit, particularly if different groups administer bed control and triage. Specialty-specific differences may exist even when a single team controls triage. Variability in resource utilization has important implications for cost-containment and triage.

Methods

Patients admitted to a single, closed medical/surgical ICU with full-time intensivists and unified triage control in a large, university-affiliated hospital were evaluated during 2011 to 2012. Patients who died in the ICU were excluded. The days of discharge (D/C) and severity using APACHE IV and its related Acute Physiology Score (APS) component were calculated daily for the first 7 days. Trend was assessed across days by Cuzick's test.

Results

A total of 719 surgical and 925 medical patients met inclusion criteria. In total, 20.2% of surgical and 21.3% of medical patients had an ICU LOS <1; P = 0.58. Admission severity was correlated with length of stay, P = 0.014 for both medical and surgical patients. Medical patients are sicker on admission and D/C from the ICU than surgical patients (P 0.05) (Figure 1).

Figure 1
figure1

abstract P490

Conclusion

ICU utilization differed by patient type even with unified triage control within a single unit. Surgical patients were less severely ill on admission to and D/C from the ICU. A significant percentage of medical and surgical patients are D/C within 1 day and may be more efficiently served in a less resource-intensive environment. The reasons for the differences in ICU utilization for surgical versus medical patients require clarification and may have implications for both resource utilization and cost.

Author information

Affiliations

Authors

Corresponding author

Correspondence to BH Nathanson.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Nathanson, B., McGee, W., Lederman, E. et al. Differences in severity and resource utilization for medical and surgical ICU patients. Crit Care 17, P490 (2013). https://doi.org/10.1186/cc12428

Download citation

Keywords

  • Resource Utilization
  • Single Unit
  • Medical Patient
  • Significant Percentage
  • Meet Inclusion Criterion