Tiffany Cao, BS
University of Maryland School of Medicine
Baltimore, MD
Disclosure information not submitted.
Leenah Afridi, n/a
Student
University of Maryland Research Associate Program, United States
Disclosure information not submitted.
Ikram Afridi, BS
Student
University of Maryland Research Associate Program, United States
Disclosure information not submitted.
.jpg "Nikki Emamian (she/her/hers) photo")
Manal Faisal, n/a
Student
University of Maryland Research Associate Program, United States
Disclosure information not submitted.
Iana Sahadzic, n/a
Student
University of Maryland Research Associate Program, United States
Disclosure information not submitted.
Saman Tanveer, BS
Student
University of Maryland SOM Department of Emergency Medicine, United States
Disclosure information not submitted.
Emilie Berman, BS
Student
University of Maryland, College Park
College Park, Maryland, United States
Disclosure information not submitted.
Nelson Chen, BS
Student
University of Maryland School of Medicine, United States
Disclosure information not submitted.
Allison Karwoski, BS
Student
University of Maryland School of Medicine, United States
Disclosure information not submitted.
Adelina Buganu, MD
Resident
8Department of Emergency Medicine, Mercer University at Coliseum Medical Center, Macon, Georgia, USA, United States
Disclosure information not submitted.
Taylor Miller, MD
Resident
University of Maryland Medical System
Baltimore, MD
Disclosure information not submitted.
Katie Andersen, ACNP, BSN, MSN
University of Maryland Medical Center, R. Adams Cowley Shock Trauma Center
Baltimore, MD, United States
Disclosure information not submitted.
.jpg "Ann Matta, ACNP, , MSN photo")
Ann Matta, ACNP, , MSN
Nurse Practitioner
University of Maryland Medical Center, Maryland, United States
Disclosure information not submitted.
Kim Boswell, MD (she/her/hers)
University of Maryland Medical Center, R. Adams Cowley Shock Trauma Center
Baltimore, MD
Disclosure information not submitted.
Daniel Haase, MD, (he/him/his)
Associate Professor of Emergency Medicine and Surgery
R. Adams Cowley Shock Trauma Center
Baltimore, MD
Disclosure information not submitted.
Elizabeth Powell, MD
Assistant Professor of Emergency Medicine
University of Maryland School of Medicine, United States
Disclosure information not submitted.
William Teeter, MD
Physician
University of Maryland School of Medicine, United States
Disclosure information not submitted.
Austin Widjaja
Student
1The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA, United States
Disclosure information not submitted.
Quincy Tran, MD, PhD, FCCM
Associate Professor
University of Maryland Medical Center
Baltimore, MD, United States
Disclosure information not submitted.
Title: Predictors for Early Bed Assignment From Other Hospitals To The Critical Care Resuscitation Unit
Introduction: The Critical Care Resuscitation Unit (CCRU) at the University of Maryland Medical Center (UMMC) facilitates prompt transfer and resuscitation of critically ill patients that require interventions unavailable at other facilities. The rapidity of transfer to definitive treatment impacts the outcome of many time-sensitive conditions. We sought to investigate patients’ characteristics and logistical factors associated with patients’ expeditious transfer to the CCRU. We hypothesized that more critically ill patients would be transferred faster.
Methods: We conducted a retrospective analysis of patients transferred to the CCRU from January 1, 2018 to December 31, 2018. Patients requiring an intensive care unit (ICU) from within our medical center were excluded. Demographics, medical history, clinical and transfer data were collected and evaluated for impact on transfer timing to our facility. Primary outcome was the intervals from transfer request-to-bed assignment (CNSLT-Bed) by the CCRU. We used multivariable logistic regression to measure associations of independent variables and outcome.
Results: Of the 1,741 CCRU patients transferred in 2018, 1,424 patients were included in analysis with a mean age of 57±17, 776 (54%) patients receiving surgical intervention, mean SOFA score of 4±4 points, and median time from transfer request to CCRU bed assignment time of 8 [IQR, 0-70] minutes. Using median CNSLT-Bed as a cutoff point, we identified the following patient characteristics associated with near immediate bed assignment: each SOFA score increment indicating a 4% higher likelihood (OR 1.04; 95% CI, 1.0005–1.074, P = 0.034), requiring urgent surgical intervention within 12 hours (334 patients [23%]; OR, 2.7; 95% CI, 1.9–3.9, P < 0.001), Stroke Neurology as accepting service (OR, 5.7; 95% CI, 2.9–10.9, P < 0.001). Nighttime acceptance of transfer request (1900-0659 hour) was associated with a reduction of likelihood of having a near-immediate bed assignment time (OR, 0.5; 95% CI, 0.4–0.7, P < 0.001).
Conclusions: The CCRU expedited transfer for critically ill patients. The need for urgent neurologic or surgical intervention, higher SOFA scores were associated with near-immediate CCRU bed assignment, with request for transfer during the nighttime associated with slower bed assignment.