The Critical Care Resuscitation Unit Transfers More Patients From Emergency Departments Faster and Is Associated With Improved Outcomes

Transfer delays of critically ill patients from other hospitals' emergency departments (EDs) to an appropriate referral hospital's intensive care unit (ICU) are associated with poor outcomes. We hypothesized that an innovative Critical Care Resuscitation Unit (CCRU) would be associated wit...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of emergency medicine 2020-02, Vol.58 (2), p.280-289
Main Authors: Tran, Quincy K., O'Connor, James, Vesselinov, Roumen, Haase, Daniel, Duncan, Rebecca, Aitken, Ashley, Rea, Jeffrey H., Jones, Kevin, Dinardo, Theresa, Scalea, Thomas, Menaker, Jay, Rubinson, Lewis
Format: Article
Language:English
Subjects:
Aged
Critical Care
critical illness
Emergency Service, Hospital
Female
Humans
Intensive Care Units - statistics & numerical data
interhospital transfer
Male
Maryland
Middle Aged
Outcome Assessment, Health Care
Patient Transfer
resuscitation unit
Retrospective Studies
Time-to-Treatment
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Transfer delays of critically ill patients from other hospitals' emergency departments (EDs) to an appropriate referral hospital's intensive care unit (ICU) are associated with poor outcomes. We hypothesized that an innovative Critical Care Resuscitation Unit (CCRU) would be associated with improved outcomes by reducing transfer times to a quaternary care center and times to interventions for ED patients with critical illnesses. This pre–post analysis compared 3 groups of patients: a CCRU group (patients transferred to the CCRU during its first year [July 2013 to June 2014]), a 2011-Control group (patients transferred to any ICU between July 2011 and June 2012), and a 2013-Control group (patients transferred to other ICUs between July 2013 and June 2014). The primary outcome was time from transfer request to ICU arrival. Secondary outcomes were the interval between ICU arrival to the operating room and in-hospital mortality. We analyzed 1565 patients (644 in the CCRU, 574 in the 2011-Control, and 347 in 2013-Control groups). The median time from transfer request to ICU arrival for CCRU patients was 108 min (interquartile range [IQR] 74–166 min) compared with 158 min (IQR 111–252 min) for the 2011-Control and 185 min (IQR 122–283 min) for the 2013-Control groups (p 
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2019.09.041