Introduction
Methods
Study design
Vital sign measurements and processing
Data collection for disease severity scores
Study outcome parameters
Statistical analysis
Results
Patient characteristics
Total | pre | post | p-value | |
---|---|---|---|---|
Unique patients, n | 136 | 82 | 54 | |
Hospital admissions, n | 138 | 84 | 54 | |
Unplanned ICU transfers, n | 152 | 93 | 59 | |
Age, median years (IQR) | 67 (58 – 72) | 67 (58 – 74) | 64 (55 – 71) | .182 |
Female gender, n (%) | 65 (43) | 38 (41) | 27 (46) | .552 |
Referring ward, n (%) | ||||
− Surgical − Internal medicine | 87 (57) 65 (43) | 52 (56) 41 (44) | 35 (59) 24 (41) | .679 |
Transfer ward | ||||
− ICU − MCU | 101 51 | 60 (65) 33 (35) | 41 (69) 18 (31) | .527 |
GCS on ICU transfer, median (IQR) | 15 (15 – 15) | 15 (15 – 15) | 15 (15 – 15) | .637 |
Mean vital signs on ICU transfer (SD) | ||||
− Systolic BP − Heart rate | 126 (32) 103 (23) | 128 (31) 104 (22) | 124 (34) 102 (25) | .619 .438 |
Diagnosis on ICU arrival | ||||
− Pulmonary • Insufficiency unspecified • Embolism | 57 56 1 | 34 34 0 | 23 22 1 | .763 |
− Infectious • Sepsis • Pneumonia • Not specified | 53 25 7 21 | 33 16 4 13 | 20 9 3 8 | .842 |
− Bleeding | 14 | 8 | 6 | .745 |
− Cardio/vascular • AF • Heart failure • IHCA • Epidural induced hypotension | 10 4 2 2 2 | 7 4 2 0 1 | 3 0 0 2 1 | .554 |
− Depressed LOC | 9 | 8 | 1 | .79 |
− Other • Auto-inflammatory • (Auto-)intoxication • Bowel ischaemia/obstruction • Acute pain | 9 3 2 3 1 | 3 1 1 1 0 | 6 2 1 2 1 | .077 |
Disease severity assessment
Disease severity scores | pre (n = 91) | Post (n = 56) | |||
---|---|---|---|---|---|
Median | IQR | Median | IQR | P-value | |
SOFA | 3 | 2 – 6 | 4 | 2 – 7 | .574 |
APACHE II | 17 | 14 – 20 | 16 | 14 – 21 | .824 |
APACHE II probability* | .26 | .13 – .38 | .28 | .17 – .40 | .474 |
APACHE IV | 59 | 46 – 67 | 50 | 36 – 65 | .187 |
APACHE IV Probability* | .26 | .13 – .44 | .32 | .14 – .45 | .446 |
Secondary outcomes
n pre/post | pre | post | ||||
---|---|---|---|---|---|---|
Median | IQR | Median | IQR | P-value | ||
ICU LOS, days | 93/59* | 3.0 | 1.7 – 5.8 | 3.1 | 1.6 – 6.1 | .962 |
Hospital LOS, days | 84/54** | 23.6 | 11.5 – 38.0 | 19.0 | 13.9 – 39.2 | .880 |
ICU Mortality (%) | 82/54*** | 11 (13) | 10 (19) | .420 | ||
Mechanical ventilation (%) | 60/41**** | 28 (47) | 22 (54) | .490 |
All shifts | ||||||
---|---|---|---|---|---|---|
Validated MEWSs* pre | Validated MEWSs* post | 20% extra sets in between ** pre | 39% extra sets in between ** post | Total vital sign sets*** pre | Total vital sign sets*** post | |
Number of uICUs | ||||||
Sets per uICU Mean Median | 92 6.8 (3.3) 6 (5–9) | 59 6.4 (3.5) 6 (4–8) | 63 2.5 (2.0) 2 (1–3) | 39 6.2 (8.4) 3 (2–6) | 92 8.6 (4.3) 8 (5–11.5) | 59 10.5 (8.2) 8 (6–13) |
p-value | .429 | .019 | .536 | |||
Systolic blood pressure, % (n) | 100% (629) | 100% (378) | 51% (81) | 77% (186) | 90% (710) | 91% (561) |
Heart rate, % (n) | 100% (629) | 100% (378) | 45% (72) | 76% (182) | 89% (701) | 90% (560) |
Oxygen saturation, % (n) | 100% (629) | 100% (378) | 60% (96) | 79% (190) | 92% (725) | 92% (568) |
Temperature, % (n) | 100% (629) | 100% (378) | 18% (28) | 15% (37) | 83% (657) | 67% (415) |
Respiratory rate, % (n) | 100% (629) | 100% (378) | 43% (68) | 75% (181) | 88% (697) | 90% (559) |
AVPU performance, % (n) | 100% (629) | 100% (378) | 18% (28) | 17% (41) | 83% (657) | 68% (419) |
Oxygen support, % (n) | 99% (621) | 99% (373) | 49% (79) | 79% (190) | 89% (700) | 84% (519) |
MEWS calculated | 100% (629) | 100% (378) | - | - | 80% (629) | 61% (378) |
Night shifts | ||||||
Number of uICUs | ||||||
Sets per uICU Mean Median | 70 2.6 (1.7) 2 (1–3) | 40 2.6 (1.7) 2 (1–3) | 34 1.7 (1.1) 1 (1–2) | 21 4.0 (4.8) 2 (2–4) | 92 2.6 (2.4) 2 (1–4) | 59 3.2 (4.1) 2 (0–5) |
p-value | .865 | .004 | .746 | |||
Systolic blood pressure, % (n) | 100% (182) | 100% (105) | 41% (24) | 86% (73) | 85% (206) | 93% (177) |
Heart rate, % (n) | 100% (182) | 100% (105) | 37% (22) | 85% (72) | 85% (204) | 93% (177) |
Oxygen saturation, % (n) | 100% (182) | 100% (105) | 58% (34) | 82% (70) | 90% (216) | 92% (175) |
Temperature, % (n) | 100% (182) | 100% (105) | 17% (10) | 14% (12) | 80% (192) | 62% (117) |
Respiratory rate, % (n) | 100% (182) | 100% (105) | 46% (27) | 82% (70) | 87% (209) | 92% (175) |
AVPU performance, % (n) | 100% (182) | 100% (105) | 22% (13) | 13% (11) | 81% (195) | 61% (116) |
Oxygen support, % (n) | 99% (180) | 99% (103) | 61% (36) | 62% (53) | 90% (216) | 82% (156) |
MEWS calculated | 100% (182) | 100% (105) | - | - | 76% (182) | 55% (105) |