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The Scientific World Journal
Volume 2014, Article ID 102929, 10 pages
http://dx.doi.org/10.1155/2014/102929
Research Article

Comparison of Risks Factors for Unplanned ICU Transfer after ED Admission in Patients with Infections and Those without Infections

1Department of Emergency Medicine, China Medical University Hospital, No. 2 Yude Road, North District, Taichung City 404, Taiwan
2School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
3Department of Industrial Engineering & Enterprise Information, Tunghai University, Taichung 407, Taiwan
4Department of Emergency Medicine, Cheng-Ching General Hospital, Taichung 407, Taiwan
5Program for Health Administration, Tunghai University, Taichung 407, Taiwan
6Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang-Ming University, Taipei 112, Taiwan

Received 24 August 2013; Accepted 18 October 2013; Published 2 January 2014

Academic Editors: A. Baydin and F. Catena

Copyright © 2014 Jeffrey Che-Hung Tsai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The objectives of this study were to compare the risk factors for unplanned intensive care unit (ICU) transfer after emergency department (ED) admission in patients with infections and those without infections and to explore the feasibility of using risk stratification tools for sepsis to derive a prediction system for such unplanned transfer. Methods. The ICU transfer group included 313 patients, while the control group included 736 patients randomly selected from those who were not transferred to the ICU. Candidate variables were analyzed for association with unplanned ICU transfer in the 1049 study patients. Results. Twenty-four variables were associated with unplanned ICU transfer. Sixteen (66.7%) of these variables displayed association in patients with infections and those without infections. These common risk factors included specific comorbidities, physiological responses, organ dysfunctions, and other serious symptoms and signs. Several common risk factors were statistically independent. Conclusions. The risk factors for unplanned ICU transfer in patients with infections were comparable to those in patients without infections. The risk factors for unplanned ICU transfer included variables from multiple dimensions that could be organized according to the PIRO (predisposition, insult/infection, physiological response, and organ dysfunction) model, providing the basis for the development of a predictive system.