Outcomes of Emergency Medical Patients Admitted to an Intermediate Care Unit With Detailed Admission Guidelines.
Catherine E Simpson, Sarina K Sahetya, Robert W Bradsher and 4 others
PMID 27965236WHAT IT FOUND
Emergency medical patients admitted to an intermediate care unit using detailed guidelines had a hospital mortality of 4.4%.
Most patients remained in intermediate care for at least 24 hours without needing intensive care transfer.
Key findings
01Hospital mortality among patients admitted to the intermediate care unit was 4.4%.
02The majority of patients admitted remained on the intermediate care unit for at least 24 hours and never required intensive care unit transfer.
03Patients transferred to the intensive care unit had higher severity of illness scores than those who remained in the intermediate care unit.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted at a single center, so the results may not be generalizable to other hospitals with different resources or patient populations. The study relied on retrospective chart review, and missing data for severity scores were assumed to be normal, which may have underestimated the true illness severity. The guidelines allowed for short intervals of intense care in the IMCU, which may have blurred the lines between intermediate and intensive care management. The study did not assess the causes of mortality, so it is unclear whether deaths were due to undertriage, failure of therapy, or bed availability issues.
Declared interests
No conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not interpret the low mortality rate as evidence that intermediate care is safer than intensive care for all emergency patients. The study describes outcomes in a specific unit with detailed guidelines and does not compare these results to patients admitted directly to the ICU, so relative safety cannot be inferred.