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Influence of ICU-bed availability on ICU admission decisions
BACKGROUND: The potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, where...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Paris
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695477/ https://www.ncbi.nlm.nih.gov/pubmed/26714805 http://dx.doi.org/10.1186/s13613-015-0099-z |
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author | Robert, René Coudroy, Rémi Ragot, Stéphanie Lesieur, Olivier Runge, Isabelle Souday, Vincent Desachy, Arnaud Gouello, Jean-Paul Hira, Michel Hamrouni, Mouldi Reignier, Jean |
author_facet | Robert, René Coudroy, Rémi Ragot, Stéphanie Lesieur, Olivier Runge, Isabelle Souday, Vincent Desachy, Arnaud Gouello, Jean-Paul Hira, Michel Hamrouni, Mouldi Reignier, Jean |
author_sort | Robert, René |
collection | PubMed |
description | BACKGROUND: The potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, whereas bed scarcity may result in refusal of patients likely to benefit from ICU admission. METHODS: Characteristics and outcomes of patient admitted in four ICUs with usual HBA, defined by admission refusal rate less than 11 % because of bed unavailability, were compared to patients admitted in six ICUs with usual low bed availability (LBA), i.e., an admission refusal rate higher than 10 % during a 90-day period. RESULTS: Over the 90 days, the mean number of days with no bed available was 30 ± 16 in HBA units versus 48 ± 21 in LBA units (p < 0.01). The proportion of admitted patients was significantly higher in the HBA (80.1 %; n = 659/823) than in the LBA units [61.6 %: n = 480/779; (p < 0.0001)]. The proportion of patients deemed too sick to benefit from admission was higher in LBA (9.0 %; n = 70) than in the HBA (6.3 %; n = 52) units (p < 0.05). The HBA group had a significantly greater proportion of patients younger than 40 years of age (22.5 %; n = 148 versus 14 %; n = 67 in LBA group; p < 0.001) and higher proportions of patients with either high or low simplified acute physiologic score II values. CONCLUSIONS: Bed availability affected triage decisions. Units with HBA trend to admit patients too sick or too well to benefit. |
format | Online Article Text |
id | pubmed-4695477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Paris |
record_format | MEDLINE/PubMed |
spelling | pubmed-46954772016-01-08 Influence of ICU-bed availability on ICU admission decisions Robert, René Coudroy, Rémi Ragot, Stéphanie Lesieur, Olivier Runge, Isabelle Souday, Vincent Desachy, Arnaud Gouello, Jean-Paul Hira, Michel Hamrouni, Mouldi Reignier, Jean Ann Intensive Care Research BACKGROUND: The potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, whereas bed scarcity may result in refusal of patients likely to benefit from ICU admission. METHODS: Characteristics and outcomes of patient admitted in four ICUs with usual HBA, defined by admission refusal rate less than 11 % because of bed unavailability, were compared to patients admitted in six ICUs with usual low bed availability (LBA), i.e., an admission refusal rate higher than 10 % during a 90-day period. RESULTS: Over the 90 days, the mean number of days with no bed available was 30 ± 16 in HBA units versus 48 ± 21 in LBA units (p < 0.01). The proportion of admitted patients was significantly higher in the HBA (80.1 %; n = 659/823) than in the LBA units [61.6 %: n = 480/779; (p < 0.0001)]. The proportion of patients deemed too sick to benefit from admission was higher in LBA (9.0 %; n = 70) than in the HBA (6.3 %; n = 52) units (p < 0.05). The HBA group had a significantly greater proportion of patients younger than 40 years of age (22.5 %; n = 148 versus 14 %; n = 67 in LBA group; p < 0.001) and higher proportions of patients with either high or low simplified acute physiologic score II values. CONCLUSIONS: Bed availability affected triage decisions. Units with HBA trend to admit patients too sick or too well to benefit. Springer Paris 2015-12-30 /pmc/articles/PMC4695477/ /pubmed/26714805 http://dx.doi.org/10.1186/s13613-015-0099-z Text en © Robert et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Robert, René Coudroy, Rémi Ragot, Stéphanie Lesieur, Olivier Runge, Isabelle Souday, Vincent Desachy, Arnaud Gouello, Jean-Paul Hira, Michel Hamrouni, Mouldi Reignier, Jean Influence of ICU-bed availability on ICU admission decisions |
title | Influence of ICU-bed availability on ICU admission decisions |
title_full | Influence of ICU-bed availability on ICU admission decisions |
title_fullStr | Influence of ICU-bed availability on ICU admission decisions |
title_full_unstemmed | Influence of ICU-bed availability on ICU admission decisions |
title_short | Influence of ICU-bed availability on ICU admission decisions |
title_sort | influence of icu-bed availability on icu admission decisions |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695477/ https://www.ncbi.nlm.nih.gov/pubmed/26714805 http://dx.doi.org/10.1186/s13613-015-0099-z |
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