Evidence map›Paper›PMID 40838913›Full record

ArticleJACC. Advances2025

Medical Intensive Care Unit Overflow Into the Cardiac Intensive Care Unit: Insights From CCCTN Registry.

Ameesh Isath, Atul Bali, Uzair A Mahmood, David D Berg, Vivian M Baird-Zars, Erin A Bohula, Lori B Daniels, Mark Dodson, Jason N Katz, Younghoon Kwon and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 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

20 authors.

Ameesh IsathCenter for Advanced Heart Disease, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Atul BaliDepartment of Cardiology, Lenox Hill Hospital, New York, New York, USA.
Uzair A MahmoodDepartment of Cardiology, Stanford University School of Medicine, Stanford, California, USA.
David D BergLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Vivian M Baird-ZarsLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Erin A BohulaLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Lori B DanielsDivision of Cardiovascular Medicine, Department of Medicine, University of California-San Diego, La Jolla, California, USA.
Mark DodsonDepartment of Pulmonary and Critical Care Medicine, Intermountain Medical Center, Murray, Utah, USA.
Jason N KatzLeon H Charney Division of Cardiology, New York University Grossman School of Medicine, New York, New York, USA.
Younghoon KwonDivision of Cardiology, University of Washington, Seattle, Washington, USA.
Daniel LoriauxDivision of Cardiology, Department of Medicine, Duke Health, Durham, North Carolina, USA.
Srini MukundanCritical Care Cardiology, Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
L Kristin NewbyDivision of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina, USA.
Jeong-Gun ParkLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Mitchell PadkinsLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Rajnish PrasadWellstar Center for Cardiovascular Care, Marietta, Georgia, USA.
Michael A SolomonCritical Care Medicine Department, National Institutes of Health Clinical Center and Cardiovascular Branch, National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland, USA.
Sammy ZakariaDivision of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
David A MorrowLevine Cardiac Intensive Care Unit, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Howard A CooperDepartment of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA. Electronic address: howard.cooper@wmchealth.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac intensive care units (CICUs) typically manage critically ill patients with acute cardiovascular (CV) conditions but may serve patients with non-CV critical illness when medical ICU (MICU) beds are unavailable.

objectivesThe purpose of this study was to characterize the clinical profiles and outcomes of "MICU overflow" admissions to the CICU.

methodsWe used the Critical Care Cardiology Trials Network registry to compare CICU admissions without acute or major cardiac issues (MICU overflow) vs those with acute CV illness.

resultsAmong 19,912 CICU admissions (2018-2023), 923 (4.6%) were MICU overflow, ranging from 0% to 26% across centers. MICU overflow admissions had higher median Sequential Organ Failure Assessment scores than CV admissions (5 vs 3; P < 0.001) and more commonly presented with respiratory failure (50.5% vs 24.6%; P < 0.001) and noncardiogenic shock (30.9% vs 8.0%; P < 0.001). MICU overflow status was associated with similar ICU mortality (adjusted OR: 1.13; 95% CI: 0.90-1.43; P = 0.28) but higher hospital mortality (adjusted OR: 1.80; 95% CI: 1.48-2.19; P < 0.001) vs CV illness. In units where the CICU team managed all admissions, ICU mortality was higher among MICU overflow admissions than CV admissions (adjusted OR: 1.35; 95% CI: 1.02-1.80; P = 0.04), whereas in CICUs where off-unit MICU teams managed MICU overflow admissions, this mortality imbalance was not present (adjusted OR: 0.72; 95% CI: 0.47-1.11; P = 0.14; P interaction = 0.02).

conclusionsMICU overflow admissions constitute a meaningful proportion of the CICU population and present with more multisystem disease and experience higher hospital mortality compared with acute CV admissions, underscoring the need for multidisciplinary CICU teams with broad critical care expertise.

Indexed as

CCCTNCICUcritical care cardiologyMICU overflowresource utilization

Identifiers

PMID40838913
PMCPMC12541208

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.