Drs. Johnson and Mitchell Co-Author Study on Mechanically Ventilated Patients with Short Critical Care Stay

Drs. Nick Johnson and Steven Mitchell are co-authors of a recently published study that aimed to characterize a cohort of intubated emergency department (ED) patients who are extubated and discharged from the ICU within 24 hours.

The study, published in The Journal of Emergency Medicine, is titled, "A Description of Mechanically Ventilated Patients Admitted From the Emergency Department With a Short Critical Care Stay."

Alongside other physicians, the team conducted a retrospective, observational cohort study at a single-level I trauma center from January 2017 to December 2019. They included adults who were admitted to an ICU from the ED requiring invasive mechanical ventilation. Our primary outcome was the proportion of patients who were discharged from the ICU alive within 24 h.

Results:

Of 13,374 ED patients admitted to an ICU during the study period, 2871 patients were intubated and ventilated in the prehospital or ED settings. Of these, 14% were discharged alive from the ICU within 24 h of admission. Only 21% of these patients were intubated in the ED. We identified the following two distinct subpopulations comprising 62% of this short-stay group: patients with a primary discharge diagnosis of intoxication (47%) and minimally injured trauma patients (53%), with 4% of patients in both subgroups.

Conclusions:

A total of 14% of patients receiving intubation with mechanical ventilation in the prehospital environment or in the ED were discharged alive from the ICU within 24 h. We identified two distinct subgroups of patients with a short stay in intensive care who may be candidates for ED extubation, including patients with intoxication and minimally injured trauma patients.