Timing of admissions and outcome of pneumonia in intensive care units in the United Kingdom

Introduction

This study aims to assess the association between the timing of admission and outcome in patients admitted with pneumonia to ICUs in the United Kingdom.

Methods

All patients admitted to an ICU with a primary reason for admission of pneumonia were extracted from the Case Mix Programme Database. 'Early' admissions, admitted to the ICU on the day of admission to hospital (12,475), were compared with 'late' admissions, admitted to the ICU on a later date (21,948). The ICU and hospital mortality, number of organs failed, renal dysfunction, and length of stay in hospital were compared between the two groups. An association was sought between timing of admission and mortality. Patients were stratified by CURB 65 score on admission to the ICU. Mortality was compared between the two groups. Odds ratios were used to analyse data. P < 0.05 was considered significant.

Results

There were small but statistically significant differences between the two groups in mean age, APACHE II score, CURB 65 score and number of organ failures, and the presence of respiratory organ failure. There was no difference in the presence of renal dysfunction. Late admissions with pneumonia had higher ICU and hospital mortality, and longer hospital stay. At each CURB 65 score the late admissions had higher hospital mortality, which was significant at scores of 2–5 (Table 1).

Table 1 (abstract P86)

Conclusion

Early admission may reduce mortality in patients admitted to ICUs with pneumonia. CURB 65 scores could facilitate triage of patients with pneumonia.