title: Expedited admission of patients decreases duration of mechanical ventilation and shortens ICU stay.
abstract: BACKGROUND
  To determine if expedited admission (<2 hours) of critically ill patients requiring intubation and mechanical ventilation from the emergency department (ED) to the intensive care unit (ICU) decreases ICU and hospital length of stay.
  
  
  METHODS
  Patients with respiratory failure that required intubation and mechanical ventilation who were admitted to the hospital between June 2004 and May 2006 were retrospectively identified from the Project IMPACT database. Patients were divided into 2 groups based on ED length of stay: expedited (<2 hours) or nonexpedited (>2 hours).
  
  
  RESULTS
  The expedited (n = 12) and nonexpedited (n = 66) groups were comparable in demographics, medical conditions, and disease severity. Mean duration of mechanical ventilation was significantly shorter in the expedited group (28.4 hours vs 67.9 hours; P = .0431), as was mean ICU length of stay (2.4 days vs 4.9 days; P = .0209). Length of hospital stay tended to be shorter for the patients in the expedited group (6.8 days vs 8.9 days; P = .0609).
  
  
  CONCLUSIONS
  Expedited admission (<2 hours) of critically ill patients requiring intubation and mechanical ventilation from the ED to the ICU was associated with shorter durations of mechanical ventilation and ICU length of stay, suggesting that prompt ICU admission results in improved use of resources.
authors.affiliation: Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI 49007, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Cline
authors.forename: Robyn A K
authors.initials: RA
authors.lastname: Schertz
authors.forename: Eric C
authors.initials: EC
authors.lastname: Feucht
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000628:therapy; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006745:Hospital Bed Capacity, 300 to 499; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010343:Patient Admission; D040841:Resource Allocation; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014600:Utilization Review