ICU Utilization After Implementation of Minor Severe Pneumonia Criteria in Real-Time Electronic Clinical Decision Support
Primary result · 30-day ICU-free daysResult — go to the resultIncrease 1.04 days 95% CI 0.48–1.59Authors' conclusion
Implementation of electronic CDS using minor sCAP criteria to guide disposition of patients with pneumonia from the ED was associated with safe reduction in ICU utilization.
Study context
- Population
- Adults admitted from the emergency department (ED) with pneumonia not requiring vasopressors or positive pressure ventilation at admission; 16 hospitals, Intermountain Health, Utah and Idaho
- Participants
- 2,747 adults · 16 hospitals
- Comparison
- Automated CDS with embedded minor severe community-acquired pneumonia (sCAP) criteria for disposition (ward vs ICU), after vs before implementation
Methodological detailsplanned secondary analysis, multicentre
- Planned secondary analysis
- Multicentre
Primary result
30-day ICU-free days · 30 days
Increase
1.04 days
95% CI 0.48–1.59
P < 0.001
Implementation vs Before
increase 1.04 days (95% CI 0.48–1.59); P < 0.001
As reported in the abstract
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Ward admission, ICU transfer within 72 h and receipt of a critical therapy · 72 hoursPost-implementation vs Pre-implementation · odds decreased by 57% | 0.43 (0.26–0.68) | P < 0.001 | |
| 30-day all-cause mortality · 30 daysPost-implementation vs Pre-implementation · lower post-implementation | 0.71 (0.52–0.96) | P = 0.03 | |
| Mortality within 72 h of admission · 72 hoursPost-implementation vs Pre-implementation · unchanged | 1.08 (0.56–2.01) | P = 0.82 | |
| 0.20.5125Odds ratio (log scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
ICU Utilization After Implementation of Minor Severe Pneumonia Criteria in Real-Time Electronic Clinical Decision Support. Crit Care Med. Published 29 December 2023. doi:10.
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