Trial reportCritical care (London, England)2012
Effects of intensivist coverage in a post-anaesthesia care unit on surgical patients' case mix and characteristics of the intensive care unit.
Trial report in Critical care (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05046925 (PACU or ICU for Postoperative Care After Major Thoracic and Abdominal Surgery：a Prospective Randomized Clinical Trial), which is not on this map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PACU or ICU for Postoperative Care After Major Thoracic and Abdominal Surgery：a Prospective Randomized Clinical Trial
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- The Association Between Hospital Capacity Strain and Inpatient Outcomes in Highly Developed Countries: A Systematic Review.Journal of general internal medicine · 2017Pooled it
- Observational
- Important aspects of the multimodal perioperative management in gynecology.Archives of gynecology and obstetrics · 2025Review
- Critical Care Management of Surgically Treated Gynecological Cancer Patients: Current Concepts and Future Directions.Cancers · 2025Review
- Economic sustainability of intensive care in Europe.Intensive care medicine · 2024Article
- Impact of Introducing a PACU24 Concept on the Perioperative Outcome of Patients with Advanced Ovarian Cancer Treated with Cytoreductive Surgery.Geburtshilfe und Frauenheilkunde · 2023Article
- The PACU as an Intensive Care Unit Before, During and After the COVID-19 Pandemic.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2022Article
- Observational
- Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model.Critical care research and practice · 2022Article
- Hospitalization and Intensive Therapy at the End of Life.Deutsches Arzteblatt international · 2019Observational
- Effect of diagnosis related groups implementation on the intensive care unit of a Swiss tertiary hospital: a cohort study.BMC health services research · 2018Observational
- Characteristics of Short-stay Critical Care Admissions From Emergency Departments in Maryland.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2017Article
- Triage of Patients Consulted for ICU Admission During Times of ICU-Bed Shortage.Journal of clinical medicine research · 2014Article
- Introducing an integrated intermediate care unit improves ICU utilization: a prospective intervention study.BMC anesthesiology · 2014Article
- APACHE IV is superior to MELD scoring system in predicting prognosis in patients after orthotopic liver transplantation.Clinical & developmental immunology · 2013Article
- The risks and rewards of expanding ICU capacity.Critical care (London, England) · 2012Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThere is an increasing demand for intensive care in hospitals, which can lead to capacity limitations in the intensive care unit (ICU). Due to postponement of elective surgery or delayed admission of emergency patients, outcome may be negatively influenced. To optimize the admission process to intensive care, the post-anaesthesia care unit (PACU) was staffed with intensivist coverage around the clock. The aim of this study is to demonstrate the impact of the PACU on the structure of ICU-patients and the contribution to overall hospital profit in terms of changes in the case mix index for all surgical patients.
methodsThe administrative data of all surgical patients (n = 51,040) 20 months prior and 20 months after the introduction of a round-the-clock intensivist staffing of the PACU were evaluated and compared.
resultsThe relative number of patients with longer length of stay (LOS) (more than seven days) in the ICU increased after the introduction of the PACU. The average monthly number of treatment days of patients staying less than 24 hours in the ICU decreased by about 50% (138.95 vs. 68.19 treatment days, P <0.005). The mean LOS in the PACU was 0.45 (± 0.41) days, compared to 0.27 (± 0.2) days prior to the implementation. The preoperative times in the hospital decreased significantly for all patients. The case mix index (CMI) per hospital day for all surgical patients was significantly higher after the introduction of a PACU: 0.286 (± 0.234) vs. 0.309 (± 0.272) P <0.001 CMI/hospital day.
conclusionsThe introduction of a PACU and the staffing with intensive care staff might shorten the hospital LOS for surgical patients. The revenues for the hospital, as determined by the case mix index of the patients per hospital day, increased after the implementation of a PACU and more patients can be treated in the same time, due to a better use of resources.
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