Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal

Introduction: The objective was to describe the clinical characteristics, disease profile and outcome of patients referred from a regional hospital Emergency Centre (EC) to the Intensive Care Unit (ICU). Methods: A retrospective review was performed using data extracted from the Integrated Critical...

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Autores principales:	Mika Singh, Roshen Maharaj, Nikki Allorto, Robert Wise
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Emergency centre Intensive care unit Critical care Decision-making Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/c42b388e8e2c4ce5a7861466eac7a171
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spelling	oai:doaj.org-article:c42b388e8e2c4ce5a7861466eac7a1712021-11-06T04:27:26ZProfile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal2211-419X10.1016/j.afjem.2021.07.006https://doaj.org/article/c42b388e8e2c4ce5a7861466eac7a1712021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2211419X21000628https://doaj.org/toc/2211-419XIntroduction: The objective was to describe the clinical characteristics, disease profile and outcome of patients referred from a regional hospital Emergency Centre (EC) to the Intensive Care Unit (ICU). Methods: A retrospective review was performed using data extracted from the Integrated Critical Care Electronic Database (iCED). Data were extracted from the database with respect to patient characteristics, Society of Critical Care Medicine (SCCM) grading, and outcome of the ICU referral. Modified early warning scores (MEWS) were calculated from EC referral data. Results: There were a total of 2187 referrals. Of these, 56.3% (1231/2187) were male. The mean age of referrals was 36 years. Of the referred patients, 41.5% (907/2187) were initially accepted for admission. A further 378 patients were accepted for admission after a follow up ICU review. Medical conditions accounted for the majority of patient referrals, followed by general surgery and trauma. Most patients initially accepted to ICU were classified as SCCM I and II and had a mean MEWS of 4. Almost half of the patients experienced a delay in admission, most commonly due to a lack of ICU bed availability. ICU mortality was 13.6% for patients admitted from the EC. Discussion: The EC population referred to the ICU was young with a high burden of medical and trauma conditions. Decisions to accept patients to ICU are limited by available resources, and there was a need to apply ICU triage criteria. Delays in the transfer of ICU patients from the EC increase the workload and contribute to EC crowding.Mika SinghRoshen MaharajNikki AllortoRobert WiseElsevierarticleEmergency centreIntensive care unitCritical careDecision-makingMedicineRMedicine (General)R5-920ENAfrican Journal of Emergency Medicine, Vol 11, Iss 4, Pp 471-476 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Emergency centre Intensive care unit Critical care Decision-making Medicine R Medicine (General) R5-920
spellingShingle	Emergency centre Intensive care unit Critical care Decision-making Medicine R Medicine (General) R5-920 Mika Singh Roshen Maharaj Nikki Allorto Robert Wise Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
description	Introduction: The objective was to describe the clinical characteristics, disease profile and outcome of patients referred from a regional hospital Emergency Centre (EC) to the Intensive Care Unit (ICU). Methods: A retrospective review was performed using data extracted from the Integrated Critical Care Electronic Database (iCED). Data were extracted from the database with respect to patient characteristics, Society of Critical Care Medicine (SCCM) grading, and outcome of the ICU referral. Modified early warning scores (MEWS) were calculated from EC referral data. Results: There were a total of 2187 referrals. Of these, 56.3% (1231/2187) were male. The mean age of referrals was 36 years. Of the referred patients, 41.5% (907/2187) were initially accepted for admission. A further 378 patients were accepted for admission after a follow up ICU review. Medical conditions accounted for the majority of patient referrals, followed by general surgery and trauma. Most patients initially accepted to ICU were classified as SCCM I and II and had a mean MEWS of 4. Almost half of the patients experienced a delay in admission, most commonly due to a lack of ICU bed availability. ICU mortality was 13.6% for patients admitted from the EC. Discussion: The EC population referred to the ICU was young with a high burden of medical and trauma conditions. Decisions to accept patients to ICU are limited by available resources, and there was a need to apply ICU triage criteria. Delays in the transfer of ICU patients from the EC increase the workload and contribute to EC crowding.
format	article
author	Mika Singh Roshen Maharaj Nikki Allorto Robert Wise
author_facet	Mika Singh Roshen Maharaj Nikki Allorto Robert Wise
author_sort	Mika Singh
title	Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
title_short	Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
title_full	Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
title_fullStr	Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
title_full_unstemmed	Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal
title_sort	profile of referrals to an intensive care unit from a regional hospital emergency centre in kwazulu-natal
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/c42b388e8e2c4ce5a7861466eac7a171
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Profile of referrals to an intensive care unit from a regional hospital emergency centre in KwaZulu-Natal

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