Profiles of the patients admitted to intermediate care units in France: Admission criteria appropriateness and potential outcome benefits (UNISURC project part 2)

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2025-04-16 DOI:10.1016/j.jcrc.2025.155078

Marc Beaussier , Bertrand Guidet , Philippe Aegerter , Christophe Baillard , Rym Boulkedid , Mathieu Desmard , Dominique Pateron , Lionelle Nkam , Benoît Misset , UNISURC Investigators

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引用次数: 0

Abstract

Background

The added value of Intermediate Care Units (IMCUs) remains controversial. This prospective, multicenter, observational cohort study aimed to: identify the characteristics of patients admitted and evaluate the appropriateness of IMCU stays according to criteria previously established in the UNISURC study; and describe the hospital trajectories and outcomes of patients admitted to IMCUs or not.

Methods

Data were collected from 12 IMCUs in seven French hospitals. All patients admitted to the IMCU from the emergency department, after intensive care unit discharge (post-ICU) or post-surgery were followed for 7 days following study inclusion. Primary and secondary outcome measures were: mortality rate over 7 days post-inclusion, demographic characteristics, IMCU-admission criteria, nursing workload assessed with the Nine Equivalents of nursing Manpower Score (NEMS).

Results

Among 437 enrolled patients, 398 were analyzed, 260 of whom were admitted to IMCUs. IMCU-admission criteria were in close accordance with previous Delphi-survey selection items (56/63 items used). For emergency department, post-ICU and post-operative trajectories, respectively, median [IQR] SAPS II at IMCU entry were: 17 [12–24], 32 [26–53] and 19 [13–25] (p < 0.05), with respective NEMS of 16 [14–27], 15 [9–21] and 18 [15–21] (p = 0.071). Crude total 7-day mortality of patients with an IMCU stay was 13/260 (5 %), compared to 15/138 (10.8 %) of those without (p = 0.048).

Conclusion

These observations provide a rationale supporting the contribution of IMCU implementation in hospitals caring for patients requiring critical-care trajectories.

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法国中级护理病房收治病人的概况：入院标准的适宜性和潜在的疗效（UNISURC 项目第 2 部分）

背景：中间护理病房（imcu）的附加价值仍然存在争议。这项前瞻性、多中心、观察性队列研究旨在：根据UNISURC研究中先前建立的标准，确定入院患者的特征并评估IMCU住院的适宜性；并描述是否入住重症监护病房的患者的住院轨迹和结果。方法收集法国7家医院12例重症监护病房的数据。所有从急诊科、重症监护病房（icu后）出院或手术后入住IMCU的患者在纳入研究后随访7天。主要和次要结局指标是：纳入后7天内的死亡率、人口统计学特征、imcu入院标准、用护理人力九等分（NEMS）评估的护理工作量。结果437例入组患者中，分析398例，其中260例入imcu。imcu的入院标准与以前的delphi调查选择项目（56/63项使用）密切相关。对于急诊科、icu后和手术后的轨迹，IMCU进入时的中位[IQR] SAPS II分别为：17[12-24]、32[26-53]和19 [13-25](p <；0.05)， NEMS分别为16[14-27]、15[9-21]和18 [15 - 21]（p = 0.071）。IMCU住院患者的7天粗总死亡率为13/260(5%)，而未住院患者的7天粗总死亡率为15/138 (10.8%)（p = 0.048）。结论这些观察结果为支持IMCU在医院对需要重症监护的患者实施的贡献提供了理论依据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.