Telemonitoring Reduces Mortality Rate Among ICU Boarders
Emergency-department–based telemonitoring reduces mortality and other outcomes among patients who are critically ill and are waiting to be transferred from the emergency department to the intensive care unit (ICU), according to a new study.
To analyze whether this ICU telemonitoring system would impact the morbidity, mortality, and ICU usage among critically ill patients awaiting transfer—a patient population referred to as “ICU boarders”—the researchers studied data from a nonprofit, tertiary care, teaching hospital that has more than 100,000 emergency department visits per year.
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During the study period, 314 patients were admitted to the medical ICU from the emergency department. In all, 214 were considered ICU boarders and were included in the study because they waited for more than 2 hours in the emergency department after having been accepted to the medical ICU.
Of the ICU boarders, 115 (53.7%) were enrolled in electronic ICU telemonitoring. The remaining patients received usual emergency department care. There were no significant differences in age, mean illness severity, or admitting diagnoses between the groups.
More patients who had received electronic ICU telemonitoring were transitioned to a less-intensive level of care—rather than be admitted to the ICU—compared with patients who received usual emergency department care (41 patients vs 0 patients).
Telemedicine-monitored ICU boarder patients who were transferred to the ICU had lower in-hospital mortality than those who had received usual emergency department care before their ICU admission (5.4% vs 20.0%).
“In critically ill patients awaiting transfer from the emergency department to the medical ICU, electronic ICU care was associated with decreased mortality and lower ICU resource utilization,” the researchers concluded.
Kadar RB, Amici DR, Hesse K, Bonder A, Ries M. Impact of telemonitoring of critically ill emergency department patients awaiting ICU transfer. Crit Care Med. 2019;47(9):1201-1207. doi:10.1097/CCM.0000000000003847.