SHM Converge Scientific Abstract ePoster Gallery-Patient Characteristics and Outcomes Associated With Unplanned Medical Icu Admissions

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This retrospective matched cohort study used the PINC AI Healthcare Database to examine 2021 adult medical and telemetry ward admissions and identify factors linked to unplanned medical ICU (MICU) transfer, defined as direct transfer from a ward to the MICU. The study included 2,855,922 medical admissions; 71,296 (2.5%) had an unplanned MICU admission.<br /><br />Patients who were more likely to require unplanned ICU care were generally male, admitted urgently/emergently, had obesity, and had a higher comorbidity burden as measured by the Charlson Comorbidity Index. The findings suggest that both medical complexity and obesity are important predictors of deterioration on the ward.<br /><br />Outcomes were substantially worse among patients with unplanned MICU admissions. Before matching, these patients had much longer ICU stays, higher ICU and total hospitalization costs, longer overall length of stay, and much higher mortality. After propensity score matching within MS-DRGs, the differences remained significant: ICU length of stay was 4.3 vs 1.2 days, ICU cost was $16,302 vs $4,948, total hospital stay was 11.4 vs 7.2 days, and total admission cost was $31,339 vs $17,916, all with p<0.0001. Mortality was also markedly higher in the unplanned MICU group (28.6% vs 7.2%).<br /><br />Overall, the analysis shows that patients with greater medical morbidity and obesity are more likely to need unplanned ICU-level care and experience worse clinical and economic outcomes after transfer.

Asset Subtitle

Roop Kaw

Meta Tag

Author List Ashish Khanna, Marilyn Moucharite, Patirck Benefield, Roop Kaw

Category Research

Concept Unplanned MICU Admission

Concept Comorbidity

Concept Charlson Comorbidity Index

Concept ICU Transfer Risk

Concept Mortality

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic

Presenting Author Roop Kaw

Track Outcomes Research

Keywords

unplanned MICU transfer

retrospective matched cohort

PINC AI Healthcare Database

medical ward admissions

telemetry ward admissions

obesity

Charlson Comorbidity Index

ICU length of stay

hospitalization costs

mortality

Unplanned MICU Admission

Comorbidity

Charlson Comorbidity Index

ICU Transfer Risk

Mortality