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.
Goldhill
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DR
The Anaesthetics Unit, St Bartholomew's and Royal London School of Medicine and Dentistry, The Royal London Hospital, Whitechapel, UK.
White
S A
SA
Sumner
A
A
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