Increase in ICU Admissions From Emergency Departments

Increase in ICU Admissions From Emergency Departments

From 2002/2003 to 2008/2009, 48.8 percent increase in ICU admissions from ERs in U.S.

MONDAY, May 20 (HealthDay News) -- From 2002/2003 to 2008/2009, there was a considerable increase in the number of patients admitted to intensive care units (ICUs) from emergency departments, according to research published in the May issue of Academic Emergency Medicine.

Peter M. Mullins, from the George Washington University School of Public Health and Health Sciences in Washington, D.C., and colleagues used data from the National Hospital Ambulatory Care Survey to describe the trends in ICU admissions from the emergency department from 2002 to 2009. The nationally representative, weighted sample included 4,267 patients (aged 18 years or older) admitted to the ICU from the emergency department, representing 14.5 million emergency department encounters.

The researchers found that ICU admissions from emergency departments increased by 48.8 percent, from 2.79 million in 2002/2003 to 4.14 million in 2008/2009, with a mean biennial increase of 14.2 percent. However, per biennial period, the mean increase in overall emergency department visits was 5.8 percent. Unspecified chest pain, congestive heart failure, and pneumonia were the three most common diagnoses for ICU admissions. There was an increase in the utilization rates of most tests and services delivered to patients admitted to the ICU from the emergency department, with the largest increase in computed tomography and magnetic resonance imaging (from 16.8 to 37.4 percent during the study period). Over the study period, there were no significant changes in the mean emergency department or hospital length of stay.

"Intensive care unit admissions from emergency departments are increasing at a greater rate than both population growth and overall emergency department visits," the authors write. "A greater emphasis on the emergency department-ICU interface and critical care delivered in the emergency department may be warranted."

Abstract (http://onlinelibrary.wiley.com/doi/10.1111/acem.12134/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1111/acem.12134/full )