Short stay in general intensive care units: is it always necessary?

  Background: There are challenges ahead of short-term hospitalization of low-risk patients hospitalized only for monitoring of severe disease who may die soon after admission. The purpose of this study was to suggest strategies for the management of ICU stay lengths and to ensure optimal use of ICU resources.   Methods: The study was conducted retrospectively on 246 patients admitted to 9 general ICUs in Tehran, from September 2011 to March 2012. Patients staying for ≤2 days in the ICU were compared to each other after being categorized into two medical and surgical groups.   Results: Of 129 patients with ≤2 days ICU stay (52.4%), 88.4% survived. Of these, 25 (19.4%) were placed in the medical and 104 (80.6%) to surgical groups. Survival rates were significantly greater in surgical group only 7.7% of them were in need of mechanical ventilation in the first 24 hours of admission (p<0.001). In contrast to medical group, the average Acute Physiology and Chronic Health Evaluation (APACHE) II score in the surgical group was significantly lower (9.8±3.6 and 17.3±5.8) (p<0.001).   Conclusion: The majority of patients with ≤2 days LOS in the surgical group hospitalized for monitoring after surgery had low mortality rate and APACHE-II score. Therefore, it would seem that transferring such patients to the intermediate care unit leads to more efficient and optimal use of ICU resources.