The impact of time taken from referral to admission into the intensive care unit on mortality and duration of admission

Abstract

This study investigated the effect of time taken from patient referral to ICU to the admission time and its effect on patient mortality and length of stay. Methods A prospective descriptive study of emergency medical and surgical patients admitted into the adult ICU at Parirenyatwa and Harare central hospitals between the months of February 2014- June 2014. Patients for whom an ICU bed was requested were followed up from the date and time they were referred to the date and time of admission. Further follow up of the length of stay and mortality was done. Delay was defined as a lead time of at least 4 hours and was compared with patients admitted within 4 hours of referral. Confounding variables examined were sex, National Early Warning System Score (NEWS), and age. Results A total of 128 patients participated in this study, 48% were delayed by more than 4 hours from referral to admission whilst 52% were admitted within 4 hours with an average lead- time of 7.5 hours and more male patients were delayed by >4 hours(63% =0.003). Patients delayed for more than 4 hours had a higher mortality (22.9%) compared to those admitted within 4 hours (18.3%). There was no significant effect of lead time to length of stay in ICU. Conclusion There is an association between time taken from referral to admission and mortality. Earlier ICU admission will lead more likely to better mortality rates in ICU.