Evidence map›Paper›PMID 31578641›Full record

ArticleAnnals of intensive care2019

Direct admission to the intensive care unit from the emergency department and mortality in critically ill hematology patients.

Olivier Peyrony, Sylvie Chevret, Anne-Pascale Meert, Pierre Perez, Achille Kouatchet, Frédéric Pène, Djamel Mokart, Virginie Lemiale, Alexandre Demoule, Martine Nyunga and 5 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. [Cancer patients in the intensive care unit].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Olivier PeyronyEmergency Department, Hôpital Saint-Louis, 1 avenue Claude Vellefaux, 75010, Paris, France. o.peyrony@hotmail.fr.ORCID http://orcid.org/0000-0001-6831-0054
Sylvie ChevretBiostatistics and Medical Information Department, Hôpital Saint-Louis, Paris, France.
Anne-Pascale MeertIntensive Care Unit, Institut Jules Bordet, Université libre de Bruxelles (ULB), Brussels, Belgium.
Pierre PerezIntensive Care Unit, Hôpital Brabois, Vandoeuvre Les Nancy, France.
Achille KouatchetIntensive Care Unit, Centre hospitalier régional universitaire, Angers, France.
Frédéric PèneUniversité de Paris, Paris, France.
Djamel MokartIntensive Care Unit, Institut Paoli Calmettes, Marseille, France.
Virginie LemialeIntensive Care Unit, Hôpital Saint-Louis, Paris, France.
Alexandre DemouleIntensive Care Unit, Hôpital Pitié-Salpêtrière, Paris, France.
Martine NyungaIntensive Care Unit, Hôpital Victor Provo, Roubaix, France.
Fabrice BruneelIntensive Care Unit, Hôpital André Mignot, Versailles, France.
Christine LebertIntensive Care Unit, Centre hospitalier départemental Vendee, La Roche Sur Yon, France.
Dominique BenoitIntensive Care Unit, Hôpital universitaire de Ghent, Ghent, Belgium.
Adrien MirouseIntensive Care Unit, Hôpital Saint-Louis, Paris, France.
Elie AzoulayCentre de Recherche en Épidémiologie et Statistiques - Université de Paris (CRESS-INSERM-UMR1153), Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation Assessments (ECSTRRA) Team, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to assess the benefit of direct ICU admission from the emergency department (ED) compared to admission from wards, in patients with hematological malignancies requiring critical care.

methodsPost hoc analysis derived from a prospective, multicenter cohort study of 1011 critically ill adult patients with hematologic malignancies admitted to 17 ICU in Belgium and France from January 2010 to May 2011. The variable of interest was a direct ICU admission from the ED and the outcome was in-hospital mortality. The association between the variable of interest and the outcome was assessed by multivariable logistic regression after multiple imputation of missing data. Several sensitivity analyses were performed: complete case analysis, propensity score matching and multivariable Cox proportional-hazards analysis of 90-day survival.

resultsDirect ICU admission from the ED occurred in 266 (26.4%) cases, 84 of whom (31.6%) died in the hospital versus 311/742 (41.9%) in those who did not. After adjustment, direct ICU admission from the ED was associated with a decreased in-hospital mortality (adjusted OR: 0.63; 95% CI 0.45-0.88). This was confirmed in the complete cases analysis (adjusted OR: 0.64; 95% CI 0.45-0.92) as well as in terms of hazard of death within the 90 days after admission (adjusted HR: 0.77; 95% CI 0.60-0.99). By contrast, in the propensity score-matched sample of 402 patients, direct admission was not associated with in-hospital mortality (adjusted OR: 0.92; 95% CI 0.84-1.01).

conclusionsIn this study, patients with hematological malignancies admitted to the ICU were more likely to be alive at hospital discharge if they were directly admitted from the ED rather than from the wards. Assessment of early predictors of poor outcome in cancer patients admitted to the ED is crucial so as to allow early referral to the ICU and avoid delays in treatment initiation and mis-orientation.

Indexed as

Direct admissionEmergency departmentHematological malignancyIntensive care unit

Identifiers

PMID31578641
PMCPMC6775178

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.