Please use this identifier to cite or link to this item: https://doi.org/10.1183/09031936.00154209
Title: The impact of a delay in intensive care unit admission for community-acquired pneumonia
Authors: Phua, J. 
Ngerng, W.J.
Lim, T.K. 
Keywords: Admission
Emergency treatment
Intensive care unit
Mortality
Pneumonia
Resuscitation
Issue Date: 1-Oct-2010
Citation: Phua, J., Ngerng, W.J., Lim, T.K. (2010-10-01). The impact of a delay in intensive care unit admission for community-acquired pneumonia. European Respiratory Journal 36 (4) : 826-833. ScholarBank@NUS Repository. https://doi.org/10.1183/09031936.00154209
Abstract: The primary objective of the present study was to evaluate the effect on hospital mortality of a delay in intensive care unit (ICU) admission for severe community-acquired pneumonia (CAP). The secondary objectives were to assess if such delays were associated with treatment variations by the emergency department (ED) and deterioration in the general wards, and to evaluate the prognostic ability of the Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria. We retrospectively compared patients who were admitted straight from the ED to the ICU (direct group, n=54) and those who were first admitted from the ED to the general wards before ICU transfer (delayed group, n=49), over 2.5 yrs. Even after excluding patients who required mechanical ventilation and/or vasopressors at the ED, delayed ICU admission was an independent predictor of hospital mortality (OR 9.61). The delayed group received fewer fluid boluses in the ED and rapidly deteriorated in the general wards. The presence of ≥3 IDSA/ATS minor criteria was associated with increased mortality in the delayed group. In conclusion, prompt recognition of severe CAP using the IDSA/ATS minor criteria, followed by aggressive management at the ED and direct ICU admission, are all crucial toward improving outcomes. Copyright©ERS 2010.
Source Title: European Respiratory Journal
URI: http://scholarbank.nus.edu.sg/handle/10635/125463
ISSN: 09031936
DOI: 10.1183/09031936.00154209
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