SHM Converge Scientific Abstract ePoster Gallery-Demographics and Hospital Outcomes of Patients Determined to Not Benefit From Icu Level Care at Time of Care Escalation Triage

Demographics and Hospital Outcomes of Patients Determined to Not Benefit From Icu Level Care at Time of Care Escalation Triage

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This retrospective quality improvement chart review examined 65 critically ill hospitalized patients for whom ICU consultation was requested at admission or during hospitalization, but who were judged unlikely to benefit from ICU-level escalation. The study aimed to better characterize these patients in order to improve resource allocation and support for care outside the ICU.<br /><br />The most common reason for ICU triage was hypotension. Many patients had serious baseline illness and poor functional status, and nearly two-thirds required advanced support such as non-titratable vasopressors or mechanical ventilation. Despite being declined ICU admission, these patients remained significantly ill on the medical wards.<br /><br />Hospital outcomes were poor overall: most patients either had poor functional status or died during the index hospitalization. However, about 20% survived to hospital discharge. Among patients who received palliative care consultation, more survived to discharge, suggesting that palliative involvement may be associated with better supportive management and outcomes.<br /><br />The findings showed that patients declined ICU admission were still medically complex and resource-intensive, even if they were not expected to benefit from ICU care. Based on these results, the institution added support services for this population, including a physician extender and increased access to palliative care and critical care consultation.

Asset Subtitle

Kyle Nelson

Meta Tag

Author List Ari Zimmer, Beth Raucher, Krishna A. Chokshi, Kyle Nelson, Vinh-Tung P. Nguyen

Category Research

Concept Intensive Care Unit Admission Decline

Concept Critically Ill Patients

Concept Hypotension

Concept Triage Request

Concept Acute Instability

Distinguished Non-Finalist

Presenter Organization The Mount Sinai Hospital

Presenting Author Kyle Nelson

Track Quality Improvement

Keywords

ICU consultation

quality improvement

retrospective chart review

critically ill patients

ICU triage

hypotension

palliative care consultation

resource allocation

hospital outcomes

critical care support

Intensive Care Unit Admission Decline

Critically Ill Patients

Hypotension

Triage Request

Acute Instability