The characteristics of very short stay ICU admissions and implications for optimizing ICU resource utilization: the Saudi experience

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Abstract
Objective. Patients with very short stays (Design. Prospective cohort study. Setting. Adult medical/surgical ICU in a tertiary care teaching hospital. Study participants. All admissions in an adult ICU from March 1999 to February 2001 and staying 0. Results. Patients staying n = 304) formed 27.8% of all ICU admissions, with an ICU mortality rate of 26.3%. Only 45.4% of them utilized ICU-specific procedures. Around one-third (32.6%) were elective admissions comprising younger patients, with a significantly lower prevalence of chronic illness, a lower ROD, and utilization of less ICU-specific procedures, with very few mortalities. When stratified using RODs into low-, intermediate-, and high-risk groups, significant differences were found with respect to age, nature of ICU admission, presence of chronic illness, utilization of ICU-specific procedures, having do-not-resuscitate (DNR) orders, length of ICU stay, and ICU and hospital outcomes. Conclusions. Our study has provided crucial input for the study of strategic change towards more optimal utilization of scarce ICU resources. Implementing protocols to target ICU care to patients most likely to benefit, making DNR decisions early in the hospital stay, and operating an Intermediate Care Unit have been proposed as strategic approaches.

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