Abstract
Background: Patients admitted to an intensive care unit (ICU) requiring invasive mechanical
ventilation who are discharged alive from the ICU within 24 h are poorly characterized
in the literature. Objective: Our aim was to characterize a cohort of intubated emergency
department (ED) patients who are extubated and discharged from the ICU within 24 h.
Methods: We conducted a retrospective, observational cohort study at a single level
I trauma center from January 2017 to December 2019. We included adults who were admitted
to an ICU from the ED requiring invasive mechanical ventilation. Our primary outcome
was the proportion of patients who were discharged from the ICU alive within 24 h.
Results: Of 13,374 ED patients admitted to an ICU during the study period, 2871 patients
were intubated and ventilated in the prehospital or ED settings. Of these, 14% were
discharged alive from the ICU within 24 h of admission. Only 21% of these patients
were intubated in the ED. We identified the following two distinct subpopulations
comprising 62% of this short-stay group: patients with a primary discharge diagnosis
of intoxication (47%) and minimally injured trauma patients (53%), with 4% of patients
in both subgroups. Conclusions: A total of 14% of patients receiving intubation with
mechanical ventilation in the prehospital environment or in the ED were discharged
alive from the ICU within 24 h. We identified two distinct subgroups of patients with
a short stay in intensive care who may be candidates for ED extubation, including
patients with intoxication and minimally injured trauma patients.
Keywords
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Article info
Publication history
Published online: March 04, 2023
Accepted:
February 17,
2023
Received in revised form:
February 4,
2023
Received:
November 17,
2022
Publication stage
In Press Uncorrected ProofFootnotes
Abstract presented at the Society of Critical Care Medicine Critical Care Congress, April 18–22, 2022, held virtually.
Identification
Copyright
Published by Elsevier Inc.
