ArticleJournal of anesthesia, analgesia and critical care2025
Critical emergency medicine unit: a new model to mitigate critically ill patient boarding in emergency department.
Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 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
- Association between prolonged Emergency Department stay and Intensive Care Unit mortality among patients at a tertiary hospital in Ethiopia.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2026Article
- Construction of an integrated treatment and management model for psychiatric emergency and intensive care units in a specialized psychiatric hospital: practice of subspecialty development.Frontiers in health services · 2025Review
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoarding of critically ill patients in the emergency department (ED) is an emerging problem that increases mortality. We have developed a "CREM Unit (critical emergency medicine unit)" led by an anesthetist-intensivist who manages critical patients directly in the ED. This study aims to assess whether the CREM Unit is an effective model for mitigating the boarding of critical patients in the ED and the impact of this on mortality.
methodThis is a retrospective observational study. We collected all patients assigned to the CREM Unit from January 1, 2019, to December 31, 2021. As our primary endpoints, we calculated ED boarding rate and the impact of boarding time on mortality. As a secondary endpoint, we compared observed 28-day mortality to Simplified Acute Physiology Score (SAPS II) predicted mortality.
resultsPatients managed by the CREM unit were 127 in 2019, 181 in 2020, and 206 in 2021, with a clear upward trend, for a total of 514 patients (p < 0.001). Overall boarding rate was 13.9%, and length of stay in ED was not associated with an increased mortality (p = 0.399). Observed mortality was compared with expected mortality, estimated from the SAPS II score for a group of inpatients (n = 295). Moreover, the median value of SAPS II for inpatients was 54 (40.5-69.0), with an expected mortality of 55.3%, while the observed mortality was 36.8% (95% CI 31.9% to 42.1%, p < 0.0001).
conclusionsOver the years, the number of patients assigned to the CREM Unit has grown steadily. These data suggest that the CREM Unit cares for a significant number of critically ill patients and could have a well-defined role both in keeping their boarding low and may contribute to reducing its impact on mortality.
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