title: Epidemiology of admissions to 11 stand-alone high-dependency care units in the UK.
abstract: OBJECTIVE
  High-dependency care units (HDUs) are a focus of research to optimize critical care resource allocation. HDUs provide a level of care between the general ward and the intensive care unit (ICU). However, few data report on the case mix and outcomes of patients in these units.
  
  
  METHODS
  Retrospective observational cohort study of patients admitted to 11 stand-alone HDUs in the UK from 2008 to 2011. We stratified patients by location prior to HDU admission and location on discharge from HDU, and we summarized the case mix, transitions of care, and mortality.
  
  
  RESULTS
  Of 9008 patients admitted to 11 stand-alone HDUs, 56.5% were male and the mean age was 62.7 ± 17.9 years. The majority of patients admitted to HDUs were non-surgical (59.3%), with 22.4 and 20.1% admitted from the ICU and general ward, respectively; 41.3% were admitted from the operating room or recovery suite. The median length of stay in HDU was 1.8 days (IQR 0.9-3.5) and in-HDU mortality was 5.1%. Among HDU survivors (n = 8551), 8.5% were discharged to an ICU, 80.9% to a general ward, and 10.6% to other care areas. For patients admitted to HDU from an ICU, only 5.8% were readmitted to ICU. Hospital mortality for the HDU population was 14.8%; for patients discharged to an ICU, hospital mortality was 43.6%.
  
  
  CONCLUSIONS
  In a sample of 11 stand-alone HDUs in the UK, patients are from many different hospital locations. Hospital mortality for patients requiring HDU care is high, particularly for patients who require transfer to an ICU.
authors.affiliation: Department of Anesthesiology, Columbia University, New York, NY, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Prin
authors.affiliation: Intensive Care National Audit and Research Centre, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Harrison
authors.affiliation: Intensive Care National Audit and Research Centre, London, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Rowan
authors.affiliation: Department of Anesthesiology, Columbia University, New York, NY, USA. hannah.wunsch@sunnybrook.ca.|Department of Critical Care Medicine, Sunnybrook Health Sciences Centre and Sunnybrook Research Institute, 2075 Bayview Avenue, Room D1.08, Toronto, ON, M4N 3M5, Canada. hannah.wunsch@sunnybrook.ca.|Department of Anesthesiology, University of Toronto, Toronto, ON, Canada. hannah.wunsch@sunnybrook.ca.
authors.forename: Hannah
authors.initials: H
authors.lastname: Wunsch
mesh_terms: D000368:Aged; D003266:Continuity of Patient Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D003422:Critical Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D003953:Diagnosis-Related Groups / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D040841:Resource Allocation / Q000191:economics / Q000592:standards; D012189:Retrospective Studies; D013222:State Medicine / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D014218:Triage; D006113:United Kingdom / Q000453:epidemiology
keywords: Continuity of patient care; Critical care; Intensive care; Triage