Abstract
BackgroundThe transfer time for critically ill patients from the emergency department (ED) to the Intensive care unit (ICU) must be minimal; however, some factors prolong the transfer time, which may delay intensive care treatment and adversely affect the patient’s outcome.PurposeTo identify factors affecting intensive care unit admission of critically ill patients from the emergency department.Patients and methodsA cross-sectional study design was conducted from January 13 to April 12, 2020, at the emergency department of Tikur Anbesa Specialized Hospital. All critically ill patients who need intensive care unit admission during the study period were included in the study. A pretested structured questionnaire was adapted from similar studies. The data were collected by chart review and observation. Then checked data were entered into Epi-data version 4.1 and cleaned data was exported to SPSS Version 25 for analysis. Descriptive statistics, bivariate and multivariate logistic regression were used to analyze the data.ResultFrom the total of 102 critically ill patients who need ICU admission 84.3% of them had prolonged lengths of ED stay. The median length of ED stay was 13.5 h with an IQR of 7–25.5 h. The most common reasons for delayed ICU admission were shortage of ICU beds 56 (65.1%) and delays in radiological examination results 13(15.1%). On multivariate logistic regression p < 0.05 male gender (AOR = 0.175, 95% CI: (0.044, 0.693)) and shortage of ICU bed (AOR = 0.022, 95% CI: (0.002, 0.201)) were found to have a significant association with delayed intensive care unit admission.Conclusionthere was a delay in ICU admission of critically ill patients from the ED. Shortage of ICU bed and delay in radiological investigation results were the reasons for the prolonged ED stay.
Highlights
An emergency department (ED) is a hospital unit responsible for managing and stabilizing sick patients in need of immediate care, followed by a transfer to the appropriate health care provider, but when patients are critically ill and require intensive care and monitoring they must be admitted to the intensive care unit timely [1,2,3,4,5].The transfer time of critically ill patients from the ED to the Intensive care unit (ICU) must be short, according to the recommendations of the Society of Critical Care Medicine (SOCCM) [2]
Socio-demographic characteristics A total of 102 critically ill patients who needed and consulted for ICU care were observed during the data collection period and their recorded data were collected
The results were relatively comparable with a study conducted in Ethiopia among 431 critically ill patients who need ICU admission; the results reported that around 67.5% of the patients had delayed ICU admission [15], This number discrepancy might occurred due to that, this previous study conducted in Ethiopia was included the pediatric ED patients, besides sociodemographic characteristics of patients might change over time
Summary
The transfer time of critically ill patients from the ED to the ICU must be short, according to the recommendations of the Society of Critical Care Medicine (SOCCM) [2]. In Ethiopia, limited studies show that critically ill patients spent a prolonged time in the ED and they had poor outcomes due to limited critical care services [14, 15]. The transfer time for critically ill patients from the emergency department (ED) to the Intensive care unit (ICU) must be minimal; some factors prolong the transfer time, which may delay intensive care treatment and adversely affect the patient’s outcome. Purpose: To identify factors affecting intensive care unit admission of critically ill patients from the emergency department
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