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BMC Emergency Medicine

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Open Access 01-12-2021 | Emergency Medicine | Research

Emergency department admissions to the intensive care unit – a national retrospective study

Authors: Susanne B. Wilhelms, Daniel B. Wilhelms

Published in: BMC Emergency Medicine | Issue 1/2021

Abstract

Background

Emergency departments (EDs) see a rising number of patients, but only a small fraction of ED patients need immediate intensive care. The characteristics of these patients are mostly unknown and there is reason to believe that there are large inter-hospital differences in thresholds for intensive care admissions from the ED. The purpose of this study was to give a nationwide overview of ED admissions directly to intensive care units.

Methods

We used the Swedish Intensive care Registry to identify all patients admitted to intensive care from the ED (January 1, 2013 until June 7, 2018). The primary outcome was discharge diagnosis after intensive care (primary ICU diagnosis code). ICU mortality and” ICU admission due to only observation” were analyzed as secondary outcomes.

Results

110,072 ICU admissions were included, representing 94,546 unique patients. Intoxication, trauma and neurological conditions were the most common causes for intensive care, but large variations according to age, sex and hospital type were seen. Intoxication was the most prevalent diagnosis in young adults (46.8% of admissions in 18–29 years old), whereas infectious diseases predominated in the elderly (17.0% in 65–79 years old). Overall, ICU mortality was 7.2%, but varied substantially with age, sex, type of hospital and medical condition. Cardiac conditions had the highest mortality rates, reaching 32.9%. The mortality was higher in academic centers compared to rural hospitals (9.3% vs 5.0%). It was more common to be admitted to ICU for only observation in rural hospitals than in academic centers (20.1% vs 7.8%). Being admitted to ICU only for observation was most common in patients with intoxication (30.6%).

Conclusions

Overall, intoxication was the most common cause for ICU admission from the ED. However, causes of ED ICU admissions differ substantially according to age, sex and hospital type. Being admitted to the ICU only for observation was most common in intoxicated patients.

Trial registration

Not applicable (no interventions).

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Title: Emergency department admissions to the intensive care unit – a national retrospective study
Authors: Susanne B. Wilhelms
Daniel B. Wilhelms
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Emergency Medicine
Intoxication
Care
Published in: BMC Emergency Medicine / Issue 1/2021
Electronic ISSN: 1471-227X
DOI: https://doi.org/10.1186/s12873-021-00517-0

At a glance: The STEP trials

Springer Medicine

Emergency department admissions to the intensive care unit – a national retrospective study

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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