ArticleCritical care explorations2020
Implementation of a Multidisciplinary Care Pathway via an Emergency Department-ICU to Improve Care of Emergency Department Patients Presenting With Leukostasis.
Article in Critical care explorations, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Critical care delivery models in emergency departments: a systematic review of the literature and meta-analysis of related outcome effects.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Pooled it
- Analysis of Emergency Department-based Intensive Care Units on Coding and Revenue.The western journal of emergency medicine · 2025Article
- Retrospective Analysis of the Impact of a Collaborative Multidisciplinary Care Model on the Efficiency of Emergency Care and Neurological Function and Prognosis of Comatose Patients With Emergency Cerebral Hemorrhage.Health science reports · 2025Article
- [Cancer patients in the emergency department].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Impact of emergency department-based intensive care unit on outcomes of decompensating boarding emergency department patients.Journal of the American College of Emergency Physicians open · 2023Article
- Emergency department length of stay and outcomes of emergency department-based intensive care unit patients.Journal of the American College of Emergency Physicians open · 2022Article
- Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?Critical care explorations · 2022Article
- Hyperleukocytic Acute Leukemia Circulating Exosomes Regulate HSCs and BM-MSCs.Journal of healthcare engineering · 2021Article
- Delivery of end-of-life care in an emergency department-based intensive care unit.Journal of the American College of Emergency Physicians open · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Leukostasis is a life-threatening complication of acute hyperleukocytic leukemia, and is associated with substantial mortality. Management of leukostasis requires time-sensitive diagnostics and therapeutics, and leukapheresis remains a mainstay of treatment in select patients. Leukapheresis requires coordination of multi-disciplinary resources, which can prove challenging in the emergency department setting, and delays in treatment due to the complexity and coordination required are common. The objective of this study was to assess the effect of utilization of an emergency department-ICU and a multidisciplinary care pathway on outcomes of critically ill leukostasis patients presenting to the emergency department.
designRetrospective cohort study.
settingSingle large academic medical center in the United States. PATIENTS: Adult emergency department patients with signs and symptoms of leukostasis requiring emergent leukapheresis from 2012-2019.
interventionsImplementation of a hybrid emergency department-ICU setting (emergency critical care center) and a multidisciplinary care pathway with members from Emergency Medicine, Hematology, Blood Bank, and Clinical Pathology. MEASUREMENTS AND MAIN
resultsA total of 70 patients were identified and included for analysis: 14 preemergency critical care center; 32 postemergency critical care center, premultidisciplinary care pathway; and 24 postemergency critical care center, postmultidisciplinary care pathway. A statistically significant reduction in the time from emergency department presentation to initiation of leukapheresis was observed from preemergency critical care center to postemergency critical care center, premultidisciplinary care pathway and postemergency critical care center, postmultidisciplinary care pathway (11.5 vs 7.9 vs 7.7 hr; CONCLUSIONS AND RELEVANCE: Implementation of a multidisciplinary care pathway via use of an emergency department-ICU for critically ill patients with leukostasis was associated with statistically significant reductions in time to leukapheresis and in-hospital mortality. These findings suggest an emergency department-ICU model may allow for maximal resource and care coordination at the point of contact with critically ill patients and improved clinical outcomes.
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