Art Christian M.

Ramos BSN IV 3

June 28, 2013 Prof. Joan M. Oyangoren

Article: Mortality Risk Increased By Delayed Transfer to the ICU ( Intensive Care Unit) Article Date: 23 May 2013 Delayed transfer to the intensive care unit (ICU) in hospitalized patients significantly increases the risk of dying in the hospital, according to a new study from researchers in Chicago. "Early intervention improves outcomes for many of the conditions that are indications for inpatient transfer to the ICU. This suggests that delaying ICU transfer may increase the risk of death in these patients," said lead author Matthew Churpek, MD, MPH, of the University of Chicago Medical Center. "Using a vital sign-based early warning score, the Cardiac Arrest Risk Triage (CART) score, we examined outcomes after delayed transfer to the ICU and found that each one hour increase in transfer delay was associated with a 7% increase in the odds of dying in the ICU." The results of the study were presented at the ATS 2013 International Conference. The study included 2,166 patients at an academic hospital who were transferred from medicalsurgical wards to the ICU. Of these patients, 425 (20%) died during admission. In a subset of 260 patients transferred to the ICU within 6 hours of a first critical CART score value, 71(27%) died during hospital admission, compared with 65 of the 143 (45%) patients for whom ICU transfer was delayed for more than 6 hours(p<0.001). Further statistical analysis revealed that each one hour increase in delay in transfer to the ICU after reaching a critical CART score was associated with a significant (p<0.001)7% increase in the odds of ICU mortality, with the chance of dying in the hospital reaching 52% among patients in whom transfer to the ICU was delayed 18-24 hours after reaching the critical CART value. "Use of an early warning score such as the CART score would allow for earlier identification of these patients and help decrease preventable in-hospital deaths associated with delayed transfer of ward patients to the ICU," said Dr. Churpek. "Further research may help determine what factors underlie delayed transfer to the ICU and whether earlier transfers can improve outcomes."

Respond: Early intervention improves outcomes in many conditions that are indications for intensive care unit (ICU) transfer, such as septic shock and respiratory failure. However, the impact of delayed ICU transfer on the mortality of critically ill ward patients is poorly characterized. This also implies to the health care system in our country because of too much accommodation of the patients admitted in the ward to be transferred in the ICU mostly happening in the government hospitals. We cant blame the government for this type of issue, thus the health care team should assess incoming patients to be admitted in the ward, or even in the ICU with quickness, accuracy and with intelligent. As we all know, the very important job of any staffs or health care team in a hospital is to assess each patient completely but the problem is there is too much patients to be handled by some health care team, thus the cause of this is that there is a delay in admission of patients in the ICU area. Base on the data of the study, each one hour increase in delay to ICU transfer was associated with a 7% increase in the odds of ICU mortality (p<0.001). This resulted in an ICU mortality of 21% in the group transferred within the first six hours of first reaching the critical CART score value to 52% in the group transferred 18-24 hours after the critical value. Delayed transfer to the ICU is associated with a significant increase in ICU and hospital mortality. Real-time use of an evidence-based early warning score, such as the CART score, could identify critically ill patients on the wards earlier and potentially decrease preventable in-hospital death and also the accurate but quick assessment of each health care team member is the most important thing to remember when in an ICU ward or area. The best solutions in health problems are always the preventive ones. Thus we, the health care team, must prevent delayed transfer of patients to the ICU for them to be able to be cured quickly and have them back on their feet as normal as possible,

Reference: American Thoracic Society. "Mortality Risk Increased By Delayed Transfer To The ICU. Medical News Today. MediLexicon, Intl., 23 May. 2013. <http://www.medicalnewstoday.com/releases/260828.php>