Physiological values and procedures in the 24 h before ICU admission from the ward.
Physiological values and interventions in the 24 h before entry to intensive care were collected for admissions from hospital wards. In a 13-month period, there were 79 admissions in 76 patients who had been in hospital for at least 24 h and had not undergone surgery within 24 h of admission to intensive care. Thirty-four per cent of patients underwent cardiopulmonary resuscitation before intensive care admission. Using Acute Physiology and Chronic Health Evaluation II scoring to quantify abnormal physiology in the group as a whole, a significant deterioration in respiratory function before admission was found. During the 6-h period immediately before intensive care admission, 75% of patients received oxygen, 37% underwent arterial blood gas sampling, and oxygen saturation was measured in 61% of patients, 63% of whom had an oxygen saturation of less than 90%. Overall hospital mortality in the study group was 58%. Information collected on the wards identified seriously ill patients who may have benefited from earlier expert treatment.
The Anaesthetics Unit, St Bartholomew's and Royal London School of Medicine and Dentistry, The Royal London Hospital, Whitechapel, UK.
D R
DR
Goldhill
S A
SA
White
A
A
Sumner
D018806:APACHE; D016887:Cardiopulmonary Resuscitation; D003422:Critical Care / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008131:London / Q000453:epidemiology; D008991:Monitoring, Physiologic; D018579:Patient Selection; D010360:Patient Transfer / Q000706:statistics & numerical data; D010362:Patients' Rooms / Q000706:statistics & numerical data; D012120:Respiration Disorders / Q000628:therapy; D013997:Time Factors