Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study)
Abstract Background Few studies address the care of critically ill non-traumatic patients in the emergency department (ED). The aim of this study was to assess the epidemiology, management, and outcome of these patients. Methods In this retrospective study, we identified and analyzed data from all c...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-023-00812-y |
| _version_ | 1797841174957916160 |
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| author | Janina Dziegielewski Falko C. Schulte Christian Jung Georg Wolff Oliver Hannappel Philipp Kümpers Michael Bernhard Mark Michael |
| author_facet | Janina Dziegielewski Falko C. Schulte Christian Jung Georg Wolff Oliver Hannappel Philipp Kümpers Michael Bernhard Mark Michael |
| author_sort | Janina Dziegielewski |
| collection | DOAJ |
| description | Abstract Background Few studies address the care of critically ill non-traumatic patients in the emergency department (ED). The aim of this study was to assess the epidemiology, management, and outcome of these patients. Methods In this retrospective study, we identified and analyzed data from all consecutive adult critically ill non-traumatic ED patients treated from March 2018 to February 2019. Patient characteristics, major complaint leading to admission, out-of-hospital, and in-hospital interventions and 30-day mortality were extracted from medical records of the electronic patient data management system. Results During the study period, we analyzed 40,764 patients admitted to the ED. Of these, 621 (1.5%) critically ill non-traumatic patients were admitted for life-threatening emergencies to the resuscitation room (age: 70 ± 16 years, 52% male). Leading problem on admission was disability/unconsciousness (D), shock (C), respiratory failure (B), airway obstruction (A), and environment problems (E) in 41%, 31%, 25%, 2%, and 1%, respectively. Out-of-hospital and in-hospital measures included: intravenous access (61% vs. 99%), 12-lead ECG (55% vs. 87%), invasive airway management (21% vs. 34%) invasive ventilation (21% vs. 34%), catecholamines (9% vs. 30%), arterial access (0% vs. 52%), and cardiopulmonary resuscitation (11% vs. 6%). The underlying diagnoses were mainly neurological (29%), followed by cardiological (28%), and pulmonological (20%) emergencies. The mean length of stay (LOS) in the resuscitation room and ED was 123 ± 122 and 415 ± 479 min, respectively. The 30-day mortality was 18.5%. Conclusion The data describe the care of critically ill non-traumatic patients in the resuscitation room. Based on these data, algorithms for the structured care of critically ill non-traumatic patients need to be developed. |
| first_indexed | 2024-04-09T16:26:49Z |
| format | Article |
| id | doaj.art-cc7f532e51c645d8a40208a73f27ccdd |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-04-09T16:26:49Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-cc7f532e51c645d8a40208a73f27ccdd2023-04-23T11:11:06ZengBMCBMC Emergency Medicine1471-227X2023-04-0123111010.1186/s12873-023-00812-yResuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study)Janina Dziegielewski0Falko C. Schulte1Christian Jung2Georg Wolff3Oliver Hannappel4Philipp Kümpers5Michael Bernhard6Mark Michael7Emergency Department, Medical Faculty, Heinrich Heine UniversityEmergency Department, Medical Faculty, Heinrich Heine UniversityDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine UniversityDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine UniversityInformation, Communication and Medicine Technology, University Hospital DuesseldorfDepartment of Medicine D, Division of General Internal and Emergency Medicine, Hypertension and Rheumatology, University Hospital MünsterEmergency Department, Medical Faculty, Heinrich Heine UniversityEmergency Department, Medical Faculty, Heinrich Heine UniversityAbstract Background Few studies address the care of critically ill non-traumatic patients in the emergency department (ED). The aim of this study was to assess the epidemiology, management, and outcome of these patients. Methods In this retrospective study, we identified and analyzed data from all consecutive adult critically ill non-traumatic ED patients treated from March 2018 to February 2019. Patient characteristics, major complaint leading to admission, out-of-hospital, and in-hospital interventions and 30-day mortality were extracted from medical records of the electronic patient data management system. Results During the study period, we analyzed 40,764 patients admitted to the ED. Of these, 621 (1.5%) critically ill non-traumatic patients were admitted for life-threatening emergencies to the resuscitation room (age: 70 ± 16 years, 52% male). Leading problem on admission was disability/unconsciousness (D), shock (C), respiratory failure (B), airway obstruction (A), and environment problems (E) in 41%, 31%, 25%, 2%, and 1%, respectively. Out-of-hospital and in-hospital measures included: intravenous access (61% vs. 99%), 12-lead ECG (55% vs. 87%), invasive airway management (21% vs. 34%) invasive ventilation (21% vs. 34%), catecholamines (9% vs. 30%), arterial access (0% vs. 52%), and cardiopulmonary resuscitation (11% vs. 6%). The underlying diagnoses were mainly neurological (29%), followed by cardiological (28%), and pulmonological (20%) emergencies. The mean length of stay (LOS) in the resuscitation room and ED was 123 ± 122 and 415 ± 479 min, respectively. The 30-day mortality was 18.5%. Conclusion The data describe the care of critically ill non-traumatic patients in the resuscitation room. Based on these data, algorithms for the structured care of critically ill non-traumatic patients need to be developed.https://doi.org/10.1186/s12873-023-00812-yEpidemiologyCritical interventionsCritically ill non-traumatic patientsEmergency department |
| spellingShingle | Janina Dziegielewski Falko C. Schulte Christian Jung Georg Wolff Oliver Hannappel Philipp Kümpers Michael Bernhard Mark Michael Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) BMC Emergency Medicine Epidemiology Critical interventions Critically ill non-traumatic patients Emergency department |
| title | Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) |
| title_full | Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) |
| title_fullStr | Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) |
| title_full_unstemmed | Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) |
| title_short | Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study) |
| title_sort | resuscitation room management of patients with non traumatic critical illness in the emergency department observe dus study |
| topic | Epidemiology Critical interventions Critically ill non-traumatic patients Emergency department |
| url | https://doi.org/10.1186/s12873-023-00812-y |
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