Implementation of a surgical intensive care unit service is associated with improved outcomes for trauma patients

Amanda L. Klein, Carlos V R Brown, Jayson Aydelotte, Sadia Ali, Adam Clark, Ben Coopwood

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Our trauma service recently transitioned from a pulmonary intensive care unit (ICU) service to a surgical ICU (SICU) service. We hypothesized that a newly formed SICU service could provide comparable outcomes to the existing pulmonary ICU service. A specific aim of this study was to compare outcomes of trauma patients admitted to the ICU before and after implementation of a SICU service.

Methods: We performed a retrospective study of trauma patients admitted to the ICU of our urban, American College of SurgeonsY verified, Level 1 trauma center during a 4-year period (2009-2012). Patients managed by the pulmonary ICU service (2009-2010) were compared with patients managed by a SICU service (2011-2012). The primary outcome was mortality, while secondary outcomes included complications (pulmonary, infectious, cardiac, and thromboembolic), hospital and ICU length of stay, ventilator days, and need for reintubation.

Results: There were 2,253 trauma patients admitted to the ICU during the study period, 1,124 and 1,129 managed by the pulmonary ICU and SICU services, respectively. When comparing outcomes for SICU and pulmonary ICU patients, there was no difference in mortality (11% vs. 13%, p = 0.41), but patients managed by the SICU service had fewer pulmonary complications (3% vs. 6%, p < 0.001), fewer days on the ventilator (3 vs. 4, p = 0.002), and less often required reintubation after extubation (4% vs. 9%, p < 0.001).

Conclusion: Transition from a pulmonary ICU service to a SICU service at our institution was associated with no change in mortality but an improvement in pulmonary complications, ventilator days, and reintubation rates. Trauma centers currently staffed with a pulmonary ICU service should feel comfortable converting to SICU service and should expect comparable or improved outcomes for trauma patients admitted to the ICU.

Original languageEnglish (US)
Pages (from-to)964-967
Number of pages4
JournalJournal of Trauma and Acute Care Surgery
Volume77
Issue number6
DOIs
StatePublished - Dec 11 2014
Externally publishedYes

Fingerprint

Critical Care
Intensive Care Units
Wounds and Injuries
Lung
Mechanical Ventilators
Trauma Centers
Mortality
Length of Stay
Retrospective Studies

Keywords

  • ICU
  • Intensivist
  • Intesive care
  • Outcomes
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery
  • Medicine(all)

Cite this

Implementation of a surgical intensive care unit service is associated with improved outcomes for trauma patients. / Klein, Amanda L.; Brown, Carlos V R; Aydelotte, Jayson; Ali, Sadia; Clark, Adam; Coopwood, Ben.

In: Journal of Trauma and Acute Care Surgery, Vol. 77, No. 6, 11.12.2014, p. 964-967.

Research output: Contribution to journalArticle

Klein, Amanda L. ; Brown, Carlos V R ; Aydelotte, Jayson ; Ali, Sadia ; Clark, Adam ; Coopwood, Ben. / Implementation of a surgical intensive care unit service is associated with improved outcomes for trauma patients. In: Journal of Trauma and Acute Care Surgery. 2014 ; Vol. 77, No. 6. pp. 964-967.
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abstract = "Background: Our trauma service recently transitioned from a pulmonary intensive care unit (ICU) service to a surgical ICU (SICU) service. We hypothesized that a newly formed SICU service could provide comparable outcomes to the existing pulmonary ICU service. A specific aim of this study was to compare outcomes of trauma patients admitted to the ICU before and after implementation of a SICU service.Methods: We performed a retrospective study of trauma patients admitted to the ICU of our urban, American College of SurgeonsY verified, Level 1 trauma center during a 4-year period (2009-2012). Patients managed by the pulmonary ICU service (2009-2010) were compared with patients managed by a SICU service (2011-2012). The primary outcome was mortality, while secondary outcomes included complications (pulmonary, infectious, cardiac, and thromboembolic), hospital and ICU length of stay, ventilator days, and need for reintubation.Results: There were 2,253 trauma patients admitted to the ICU during the study period, 1,124 and 1,129 managed by the pulmonary ICU and SICU services, respectively. When comparing outcomes for SICU and pulmonary ICU patients, there was no difference in mortality (11{\%} vs. 13{\%}, p = 0.41), but patients managed by the SICU service had fewer pulmonary complications (3{\%} vs. 6{\%}, p < 0.001), fewer days on the ventilator (3 vs. 4, p = 0.002), and less often required reintubation after extubation (4{\%} vs. 9{\%}, p < 0.001).Conclusion: Transition from a pulmonary ICU service to a SICU service at our institution was associated with no change in mortality but an improvement in pulmonary complications, ventilator days, and reintubation rates. Trauma centers currently staffed with a pulmonary ICU service should feel comfortable converting to SICU service and should expect comparable or improved outcomes for trauma patients admitted to the ICU.",
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