Characteristics of Short-stay Critical Care Admissions From Emergency Departments in Maryland

Acad Emerg Med. 2017 Oct;24(10):1204-1211. doi: 10.1111/acem.13188. Epub 2017 May 8.


Objectives: Critical care is an expensive and limited resource, and short-stay critical care admissions may be treated in alternate, less costly settings. This study objective was to determine the proportion of critical care admissions with a short critical care length of stay (LOS) and identify the clinical characteristics and diagnoses associated with high and low rates of short-stay critical care admissions.

Methods: This study was a secondary analysis of the 2011 Maryland State Inpatient Database. The study included adult emergency department (ED) visits admitted to a critical care unit. We compared clinical data and discharge diagnoses for short- (≤1 day) versus longer- (≥2 days) stay critical care admissions.

Results: A total of 30,212 critical care admissions were eligible, of which 11,494 (38.0%) were short stay. There were significant differences in age, insurance, and comorbidities between the short-stay and the longer-stay critical care admissions. Of short-stay critical care admissions, 3,404 (29.6%) also had a 1-day overall hospital LOS. The diagnoses with the highest proportion of short-stay critical care admissions were nonspecific chest pain (87.9%), syncope (70.6%), and transient cerebral ischemia (67.6%) and the lowest proportion were respiratory failure (17.9%), sepsis (19.4%), and aspiration pneumonitis (19.8%).

Conclusions: Over one-third of critical care admissions were short stay. Alternate strategies to manage these patients, including ED-based critical care units or other venues of inpatient care, may be more cost-efficient for selected patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Critical Care / economics
  • Critical Care / statistics & numerical data*
  • Databases, Factual
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data*
  • Male
  • Maryland
  • Middle Aged
  • Patient Admission / statistics & numerical data*
  • Young Adult