Organization of intensive cardiac care units in Europe: Results of a multinational survey
Por:
Claeys, MJ, Roubille, F, Casella, G, Zukermann, R, Nikolaou, N, De Luca, L, Gierlotkaa, M, Iakobishvili, Z, Thiele, H, Koutouzis, M, Sionis, A, Monteiro, S, Beauloye, C, Held, C, Tint, D, Zakke, I, Serpytis, P, Babic, Z, Belohlavev, J, Magdy, A, Rasalingam, MS, Daly, K, Arroyo, D, Vavlukis, M, Radovanovic, N, Trendafilova, E, Marandi, T, Hassenger, C, Lettino, M, Price, S, Bonnefoy, E
Publicada:
1 dic 2020
Ahead of Print:
1 ene 2020
Resumen:
Background: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe. Methods: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14). Results: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries. Conclusion: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.
Filiaciones:
Claeys, MJ:
Antwerp Univ Hosp, Dept Cardiol, Wilrijkstr Edegem 10, B-2650 Antwerp, Belgium
Roubille, F:
Univ Hosp Montpellier, Dept Cardiol, Montpellier, France
Casella, G:
Osped Maggiore Bologna, Dept Cardiol, Bologna, Italy
Zukermann, R:
Rambam Med Hlth Ctr, Haifa, Israel
Nikolaou, N:
Konstantopouleio Gen Hosp, Dept Cardiol, Nea Ionia, Greece
De Luca, L:
S Giovanni Evangelista Hosp, Dept Cardiol, Tivoli, Italy
Gierlotkaa, M:
Univ Opole, Dept Cardiol, Opole, Poland
Iakobishvili, Z:
Holon Med Ctr, Heart Inst, Holon, Israel
Thiele, H:
Univ Hosp, Heart Ctr Leipzig, Leipzig, Germany
Koutouzis, M:
Red Cross Gen Hosp, Athens, Greece
Sionis, A:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Barcelona, Spain
Monteiro, S:
Coimbra Univ Hosp, Coimbra, Portugal
Beauloye, C:
UCLouvain, Clin Univ St Luc, Louvain La Neuve, Belgium
Held, C:
Uppsala Clin Res Ctr, Dept Med Sci, Uppsala, Sweden
Tint, D:
Transilvania Univ, ICCO Clin, Brasov, Romania
Zakke, I:
Pauls Stradins Clin Univ Hosp, Riga, Latvia
Serpytis, P:
Vilnius Univ, Fac Med, Vilnius, Lithuania
Babic, Z:
Univ Hosp Ctr Sisters Mercy, Zagreb, Croatia
Belohlavev, J:
Charles Univ Prague, Dept Med 2, Prague, Czech Republic
Magdy, A:
Natl Heart Inst, Cairo, Egypt
Rasalingam, MS:
Aarhus Univ Hosp, Dept Cardiol, Aarhus, Denmark
Daly, K:
Univ Coll Hosp, Galway, Ireland
Arroyo, D:
Hop Cantonal Fribourg, Fribourg, Switzerland
Vavlukis, M:
PHO Univ Clin Cardiol, Skopje, North Macedonia
Radovanovic, N:
Clin Ctr Serbia, Emergency Ctr, Belgrade, Serbia
Trendafilova, E:
Natl Cardiol Hosp, ICCU, Sofia, Bulgaria
Marandi, T:
North Estonia Med Ctr, Tallinn, Estonia
Univ Tartu, Dept Cardiol, Tartu, Estonia
Hassenger, C:
Rigshosp, Dept Cardiol, Copenhagen, Denmark
Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
Lettino, M:
San Gerardo Hosp, Div Cardiol, Monza, Italy
Price, S:
Royal Brompton Hosp, Adult Intens Care Unit, London, England
Bonnefoy, E:
Hosp Civils Lyon, Intens Cardiac Care Unit, Lyon, France
Bronze, Green Submitted
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