Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34408
Title: Assessment of a novel marker of ICU strain, the ICU Activity Index, during the COVID-19 pandemic in Victoria, Australia.
Austin Authors: Pilcher, David V;Duke, Graeme;Rosenow, Melissa;Coatsworth, Nicholas;O'Neill, Genevieve;Tobias, Tracey A;McGloughlin, Steven;Holley, Anthony;Warrillow, Steven;Cattigan, Claire;Huckson, Sue;Sberna, Gian;McClure, Jason
Affiliation: Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Melbourne, VIC, Australia.;Department of Intensive Care, Alfred Health, Melbourne, VIC, Australia.;Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Intensive Care Service, Eastern Health, Melbourne, VIC, Australia.
Adult Retrieval Victoria, Ambulance Victoria, Melbourne, VIC, Australia.
Australian Government Department of Health, Canberra, ACT, Australia.;Australian National University Medical School, Canberra, ACT, Australia.
Adult Retrieval Victoria, Ambulance Victoria, Melbourne, VIC, Australia.
Department of Intensive Care, Alfred Health, Melbourne, VIC, Australia.;Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Intensive Care, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Intensive Care
Department of Intensive Care, University Hospital Geelong, Geelong, VIC, Australia.
Issue Date: 6-Sep-2021
Date: 2023
Publication information: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2021-09-06; 23(3)
Abstract: Objectives: To validate a real-time Intensive Care Unit (ICU) Activity Index as a marker of ICU strain from daily data available from the Critical Health Resource Information System (CHRIS), and to investigate the association between this Index and the need to transfer critically ill patients during the coronavirus disease 2019 (COVID-19) pandemic in Victoria, Australia. Design: Retrospective observational cohort study. Setting: All 45 hospitals with an ICU in Victoria, Australia. Participants: Patients in all Victorian ICUs and all critically ill patients transferred between Victorian hospitals from 27 June to 6 September 2020. Main outcome measure: Acute interhospital transfer of one or more critically ill patients per day from one site to an ICU in another hospital. Results: 150 patients were transported over 61 days from 29 hospitals (64%). ICU Activity Index scores were higher on days when critical care transfers occurred (median, 1.0 [IQR, 0.4-1.7] v 0.6 [IQR, 0.3-1.2]; P < 0.001). Transfers were more common on days of higher ICU occupancy, higher numbers of ventilated or COVID-19 patients, and when more critical care staff were unavailable. The highest ICU Activity Index scores were observed at hospitals in north-western Melbourne, where the COVID-19 disease burden was greatest. After adjusting for confounding factors, including occupancy and lack of available ICU staff, a rising ICU Activity Index score was associated with an increased risk of a critical care transfer (odds ratio, 4.10; 95% CI, 2.34-7.18; P < 0.001). Conclusions: The ICU Activity Index appeared to be a valid marker of ICU strain during the COVID-19 pandemic. It may be useful as a real-time clinical indicator of ICU activity and predict the need for redistribution of critical ill patients.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34408
DOI: 10.51893/2021.3.OA7
ORCID: 
Journal: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Start page: 300
End page: 307
PubMed URL: 38046069
Type: Journal Article
Appears in Collections:Journal articles

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