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Intensive Care Med. 2002 Nov;28(11):1629-34. Epub 2002 Sep 11.

Duration of life-threatening antecedents prior to intensive care admission.

Author information

  • 1Department of Intensive Care, Liverpool Hospital, Liverpool BC, NSW, Australia. ken.hillman@unsw.edu.au

Abstract

OBJECTIVE:

To document the characteristics and incidence of serious abnormalities in patients prior to admission to intensive care units.

DESIGN AND SETTING:

Prospective follow-up study of all patients admitted to intensive care in three acute-care hospitals.

PATIENTS:

The study population totalled 551 patients admitted to intensive care: 90 from the general ward, 239 from operating rooms (OR) and 222 from the Emergency Department (ED).

MEASUREMENTS AND RESULTS:

Patients from the general wards had greater severity of illness (APACHE II median 21) than those from the OR (15) or ED (19). A greater percentage of patients from the general wards (47.6%) died than from OR (19.3%) and ED (31.5%). Patients from the general wards had a greater number of serious antecedents before admission to intensive care 43 (72%) than those from OR 150 (64.4%) or ED 126 (61.8%). Of the 551 patients 62 had antecedents during the period 8-48 h before admission to intensive care, and 53 had antecedents both within 8 and 48 h before their admission. The most common antecedents during the 8 h before admission were hypotension (n=199), tachycardia (n=73), tachypnoea (n=64), and sudden change in level of consciousness (n=42). Concern was expressed in the clinical notes by attending staff in 70% of patients admitted from the general wards.

CONCLUSIONS:

In over 60% of patients admitted to intensive care potentially life-threatening abnormalities were documented during the 8 h before their admission. This may represent a patient population who could benefit from improved resuscitation and care at an earlier stage.

PMID:
12415452
[PubMed - indexed for MEDLINE]
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