Common laboratory tests predict imminent medical emergency team calls, intensive care unit admission or death in emergency department patients

2013 ◽  
Vol 25 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Elsa Loekito ◽  
James Bailey ◽  
Rinaldo Bellomo ◽  
Graeme K Hart ◽  
Colin Hegarty ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Laboratory Tests ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team ◽  
Emergency Department Patients ◽  
Common Laboratory

scholarly journals The risk of postoperative deterioration of non-cardiac surgery patients with ICU referral status who are admitted to the regular ward: a retrospective observational cohort study

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
David Moore ◽  
Matthew L. Durie ◽  
Sohail Bampoe ◽  
Luke Buizen ◽  
Jai N. Darvall
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Intensive Care Unit Admission ◽  
Medical Emergency Team ◽  
Surgical Patients ◽  
Medical Emergency ◽  
Improvement Program ◽  
Surgical Quality ◽  
Emergency Team

Abstract Background Higher-risk surgical patients may not be admitted to the intensive care unit due to stable immediate post-operative status on review. The outcomes of this cohort are not well described. Our aim was to examine the subsequent inpatient course of intensive care unit -referred but not admitted surgical patients. Methods All patients aged ≥18 years who were referred but not admitted for post-operative management in a tertiary metropolitan intensive care unit following non-cardiac surgery between 1/7/2017 and 30/6/2018 were eligible for inclusion in this retrospective observational cohort study. Primary outcome was Medical Emergency Team activation. Secondary outcomes included unplanned intensive care unit admission; length of stay; and 30-day mortality. Risk of serious complications and predicted length of stay were calculated using the National Surgical Quality Improvement Program scoring tool. Results Fifteen of 60 patients (25%) had a MET-call following surgery, eight (13%) patients required unplanned intensive care unit admission, with median (IQR) time to Medical Emergency Team call 9 (6–13) hours. No patients died within 30-days. There was no significant difference between mean National Surgical Quality Improvement Program predicted and actual length of stay; after adjustment, National Surgical Quality Improvement Program predicted risk of serious complications was associated with unplanned intensive care unit admission (OR [95% CI] = 1.08 [1.00–1.16], p = 0.04), although not Medical Emergency Team calls. Conclusions Post-operative deterioration occurs frequently, and early, in a cohort of high-risk surgical patients initially assessed as being safe for ward care. Changes to current triage models for post-operative intensive care unit admission may reduce the impact of complications in this high-risk group.

Is postoperative intensive care unit admission a prerequisite for elective craniotomy?

2011 ◽  
Vol 115 (6) ◽  
pp. 1236-1241 ◽  
Author(s):  
John Q. H. Bui ◽  
Rajith L. Mendis ◽  
James M. van Gelder ◽  
Mark M. P. Sheridan ◽  
Kylie M. Wright ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Loss ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Safe Alternative ◽  
Emergency Team ◽  
Icu Admission ◽  
Postoperative Intensive Care ◽  
Postoperative Intensive Care Unit

Object Routine postoperative admission to the intensive care unit (ICU) is often considered a necessity in the treatment of patients following elective craniotomy but may strain already limited resources and is of unproven benefit. In this study the authors investigated whether routine postoperative admission to a regular stepdown ward is a safe alternative. Methods Three hundred ninety-four consecutive patients who had undergone elective craniotomy over 54 months at a single institution were retrospectively analyzed. Indications for craniotomy included tumor (257 patients) and transsphenoidal (63 patients), vascular (31 patients), ventriculostomy (22 patients), developmental (13 patients), and base of skull conditions (8 patients). Recorded data included age, operation, reason for ICU admission, medical emergency team (MET) calls, in-hospital mortality, and postoperative duration of stay. Results Three hundred forty-three patients were admitted to the regular ward after elective craniotomy, whereas there were 43 planned and 8 unplanned ICU admissions. The most common reasons for planned ICU admissions were anticipated lengthy operations (42%) and anesthetic risks (40%); causes for unplanned ICU admissions were mainly unexpected slow neurological recovery and extensive intraoperative blood loss. Of the 343 regular ward admissions, 10 (3%) required a MET call; only 3 of these MET calls occurred within the first 48 postoperative hours and did not lead to an ICU admission. The overall mortality rate in the investigated cohort was 1%, with no fatalities in patients admitted to the normal ward postoperatively. Conclusions Routine ward admission for patients undergoing elective craniotomies with selective ICU admission appears safe; however, approximately 2% of patients may require a direct postoperative unplanned ICU admission. Patients with anticipated long operation times, extensive blood loss, and high anesthetic risks should be selected for postoperative ICU admission, but further study is needed to determine the preoperative factors that can aid in identifying and caring for these groups of patients.

Medical emergency team may reduce obstetric intensive care unit admissions

2016 ◽  
Vol 43 (1) ◽  
pp. 106-113 ◽  
Author(s):  
Moon Seong Baek ◽  
Jeongsuk Son ◽  
Jin Won Huh ◽  
Chae-Man Lim ◽  
Younsuck Koh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Emergency Team

F-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis

Biomarkers ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 391-396
Author(s):  
Justin B. Belsky ◽  
Michael R. Filbin ◽  
Emanuel P. Rivers ◽  
Kevin R. Bobbitt ◽  
Anja K. Jaehne ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Emergency Department ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Patients At Risk ◽  
Emergency Department Patients ◽  
Qsofa Score
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