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Prolonging ICU stay reduces the number of ward deaths: evaluation of a model for triaging ICU discharges

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A significant number of patients discharged alive from the intensive care unit (ICU) die subsequently on the general wards. A predictive model using data from the patients' last day in the ICU prior to discharge, and a 0.6 cutoff, correctly identified 66% of ward deaths. We tested the model's ability to identify those patients who may benefit from a further 24 to 48 h stay in ICU.

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All ICU survivors discharged between 1st June 1990 to 31st December 1996 who stayed for more than three days, in whom the predictive model applied within 48 h of ICU discharge, were studied. 562 patients were classified into three groups: Group (0) 311 patients last predicted to be at risk of ward death on the day of ICU discharge; Group (1) 188 patients last predicted at risk 24 h prior to ICU discharge; Group (2) 63 patients last predicted at risk 48 h prior to ICU discharge. The model was further evaluated using another two independent data sets.


See Table. Similar findings were found for the two other data sets.


There was a significant improvement in hospital survival for those patients who stayed in the ICU an additional 48 h following the prediction of ward death. If this can be confirmed in a prospective study, it will have a major impact on the provision of ICU beds in the United Kingdom.


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Daly, K., Beale, R. & Chang, R. Prolonging ICU stay reduces the number of ward deaths: evaluation of a model for triaging ICU discharges. Crit Care 4 (Suppl 1), P222 (2000).

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  • Public Health
  • Intensive Care Unit
  • Emergency Medicine
  • Predictive Model
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