A multicenter description of intermediate-care patients: comparison with ICU low-risk monitor patients.
OBJECTIVE
To describe the characteristics and outcomes of patients admitted to intermediate-care areas (ICAs) and to compare them with those of ICU patients who receive monitoring only on day 1 and are at a low risk (i.e., < 10%) for receiving subsequent active life-supporting therapy (i.e., low-risk monitor patients).


METHODS
Nonrandomized, retrospective, cohort study.


METHODS
Thirteen US teaching hospitals and 19 nonteaching hospitals.


METHODS
A consecutive sample of 8,971 patients at 37 ICAs and 5,116 low-risk (i.e., < 10%) monitor patients at 59 ICUs in 32 US hospitals.


METHODS
None.


RESULTS
We recorded demographic and clinical characteristics, resource use, and outcomes for the ICA and ICU low-risk monitor patients. Patient data and outcomes for this study were collected concurrently or retrospectively. ICA and ICU low-risk monitor patients were similar in regard to gender, race, and frequency of comorbitities, but ICA patients were significantly (p < 0.001) older, had fewer physiologic abnormalities (mean acute physiology score, 16.7 vs 19.8, respectively), and were more frequently admitted due to nonoperative diagnoses. The mean length of stay for ICA patients was significantly longer (3.9 days) than for ICU low-risk monitor patients (2.6 days; p < 0.001). The hospital mortality rate was significantly higher for ICA patients (3.1%) compared to ICU low-risk monitor patients (2.3%; p = 0.002).


CONCLUSIONS
The clinical features of ICA patients are similar, but not identical to, those of less severely ill ICU monitor patients. Comparisons of hospital death rates and lengths of stay for these patients should be adjusted for characteristics that previously have been shown to influence these outcomes.
Junker
Christopher
C
Department of Anesthesiology and Critical Care Medicine, George Washington University Medical Center, Washington, DC 20037, USA. junkers@erols.com
Zimmerman
Jack E
JE
Alzola
Carlos
C
Draper
Elizabeth A
EA
Wagner
Douglas P
DP
D018806:APACHE; D000328:Adult; D000368:Aged; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007380:Intermediate Care Facilities / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008020:Life Support Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012306:Risk; D014481:United States