Evidence map›Paper›PMID 40828442›Full record

Observational studyInternal and emergency medicine2025

Intermediate care units: an effective alternative to reduce intensive care unit admissions-a prospective cohort study.

Gianni Turcato, Arian Zaboli, Alessandro Cipriano, Paolo Ferretto, Fabrizio Lucente, Lucia Filippi, Michael Maggi, Massimo Marchetti, Christian Josef Wiedermann, Lorenzo Ghiadoni

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Internal and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

10 authors.

Gianni TurcatoDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy. gianni.turcato@yahoo.it.ORCID 0000-0002-8890-4113
Arian ZaboliInnovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Alessandro CiprianoEmergency Department, Nuovo Santa Chiara Hospital, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Paolo FerrettoDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy.
Fabrizio LucenteDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy.
Lucia FilippiDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy.
Michael MaggiDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy.
Massimo MarchettiDepartment of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 42, Santorso, Vicenza, Italy.
Christian Josef WiedermannInstitute of General Medicine and Publich Health, Claudiana, Bozen-Bolzano, Italy.
Lorenzo GhiadoniDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCritically ill medical patients from the Emergency Department (ED) are admitted either to general wards or the Intensive Care Unit (ICU). This binary allocation may lead to suboptimal management of non-intensive critical patients, increasing ICU overcrowding. Intermediate Care Units (IMCUs) could be an effective alternative, but their ability to reduce avoidable ICU admissions remains unclear.

aimTo evaluate whether an IMCU could effectively manage acutely ill patients with potential ICU treatment needs and to assess its role in reducing avoidable ICU admissions while maintaining patient outcomes.

methodsThis prospective observational study (January-December 2024) was conducted at the IMCU of Alto Vicentino Hospital, Santorso, Italy. All acute patients admitted to the IMCU were included, excluding step-down ICU transfers. Clinical characteristics, disease severity, and organ dysfunction were recorded. Patients were classified based on their potential ICU treatment need, and ICU exclusion criteria were documented. Primary outcomes were ICU transfer due to IMCU failure and 30-day mortality.

resultsAmong 678 patients, 40.4% (274/678) had potential ICU treatment needs. Overall, 92.6% had organ failure, and 41.3% had multiple organ dysfunctions. IMCU management avoided ICU admission in 203 of 274 patients (79.9%). ICU transfer rate was 6.9% (47/678), and 30-day mortality was 12.8% (87/678). Among ICU-potential patients, mortality was 16.4% (45/274), decreasing to 11.4% (27/236) in those without ICU exclusion criteria.

conclusionsThese findings suggest that IMCUs may serve as an effective alternative for managing critically ill non-intensive care patients, reducing avoidable ICU admissions while maintaining clinical outcomes.

Indexed as

Intensive Care UnitsIntermediate Care FacilitiesPatient AdmissionAgedCohort StudiesCritical IllnessFemaleHospitalizationHumansItalyMaleMiddle AgedProspective StudiesCritical illnessIntermediate care unitsOrgan failurePatient admissionPatient outcome assessment

Identifiers

PMID40828442

What OpenQuestion holds

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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.