Description

Objective:This was a U.K. based study which aimed to
identify medical patients who met criteria for high dependency care and to compare outcomes for patients managed in medical IHDU with those managed in a general ward environment.

Design:Over a 12 week period, all medical wards and medical HDU were visited daily. All patients who met criteria for admission to HDU in the U.K., irrespective of ward area, were included in the study.

Setting:1019 bedded teaching hospital.

Patients and participants: A total of 201 patients were
suitable for inclusion. The HDU group included 112 patients
(64 male; 48 female) and the ward group included 89 patients
(48 male; 41 female).

Main outcome measures: The effect of high dependency care on patient’s hospital length of stay hospital mortality and
three-month mortality.

Results: The median hospital length of stay (LOS) for the
HDU group was 5.5 days and for the ward group 14 days (p=0.00008). Hospital mortality for the HDU group was 25%, increasing to 31% at three months while hospital mortality for the ward group was 33%, rising to 35% at three months. Of the 106 ward based high dependency episodes 38 were referred to medical HDU, five to CCU (Coronary Care Unit), four to ITU (Intensive Therapy Unit) and one to surgical HDU. In 58 high dependency ward based episodes no referral to a high dependency unit was made.

Conclusion: These results suggests that patients who are
cared for in HDU have an average hospital LOS 8.5 days shorter and a hospital and three month mortality rate eight percent and four percent lower than the ward based patients.