PMID- 32067723
OWN - NLM
STAT- MEDLINE
DCOM- 20201221
LR  - 20201221
IS  - 1527-3288 (Electronic)
IS  - 0147-9563 (Linking)
VI  - 49
IP  - 4
DP  - 2020 Jul-Aug
TI  - Is my patient ready for a safe transfer to a lower-intensity care setting? 
      Nursing complexity as an independent predictor of adverse events risk after ICU 
      discharge.
PG  - 407-414
LID - S0147-9563(20)30015-7 [pii]
LID - 10.1016/j.hrtlng.2020.02.003 [doi]
AB  - BACKGROUND: Patients discharged from intensive care units (ICUs) are at risk for 
      adverse events (AEs). Establishing safe discharge criteria is challenging. No 
      available criteria consider nursing complexity among risk factors. OBJECTIVES: To 
      investigate whether nursing complexity upon ICU discharge is an independent 
      predictor for AEs. METHODS: Prospective observational study. The Patient Acuity 
      and Complexity Score (PACS) was developed to measure nursing complexity. Its 
      predictive power for AEs was tested using multivariate regression analysis. 
      RESULTS: The final regression model showed a very-good discrimination power (AUC 
      0.881; p<0.001) for identifying patients who experienced AEs. Age, ICU admission 
      reason, PACS, cough strength, PaCO(2), serum creatinine and sodium, and transfer 
      to Internal Medicine showed to be predictive of AEs. Exceeding the identified 
      PACS threshold increased by 3.3 times the AEs risk. CONCLUSIONS: The level of 
      nursing complexity independently predicts AEs risk and should be considered in 
      establishing patient's eligibility for a safe ICU discharge.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Sanson, Gianfranco
AU  - Sanson G
AD  - Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 
      Strada di Fiume 447, 34100 Trieste, Italy. Electronic address: gsanson@units.it.
FAU - Marino, Cecilia
AU  - Marino C
AD  - Department of Perioperative Medicine, Intensive Care and Emergency, University 
      Hospital, Trieste, Italy. Electronic address: cecilia_marino@tiscali.it.
FAU - Valenti, Andrea
AU  - Valenti A
AD  - Department of Perioperative Medicine, Intensive Care and Emergency, University 
      Hospital, Trieste, Italy. Electronic address: 
      andrea.valenti@asuits.sanita.fvg.it.
FAU - Lucangelo, Umberto
AU  - Lucangelo U
AD  - Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 
      Strada di Fiume 447, 34100 Trieste, Italy; Department of Perioperative Medicine, 
      Intensive Care and Emergency, University Hospital, Trieste, Italy. Electronic 
      address: u.lucangelo@fmc.units.it.
FAU - Berlot, Giorgio
AU  - Berlot G
AD  - Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 
      Strada di Fiume 447, 34100 Trieste, Italy; Department of Perioperative Medicine, 
      Intensive Care and Emergency, University Hospital, Trieste, Italy. Electronic 
      address: berlot@inwind.it.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200214
PL  - United States
TA  - Heart Lung
JT  - Heart & lung : the journal of critical care
JID - 0330057
SB  - IM
MH  - Hospitalization
MH  - Humans
MH  - *Intensive Care Units
MH  - *Patient Discharge
MH  - Prospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - Adverse events
OT  - Discharge
OT  - Intensive care unit
OT  - Nursing complexity
OT  - Risk assessment
COIS- Declaration of Competing Interest No conflict of interest has been declared by 
      the authors.
EDAT- 2020/02/19 06:00
MHDA- 2020/12/22 06:00
CRDT- 2020/02/19 06:00
PHST- 2019/10/16 00:00 [received]
PHST- 2020/01/24 00:00 [revised]
PHST- 2020/02/03 00:00 [accepted]
PHST- 2020/02/19 06:00 [pubmed]
PHST- 2020/12/22 06:00 [medline]
PHST- 2020/02/19 06:00 [entrez]
AID - S0147-9563(20)30015-7 [pii]
AID - 10.1016/j.hrtlng.2020.02.003 [doi]
PST - ppublish
SO  - Heart Lung. 2020 Jul-Aug;49(4):407-414. doi: 10.1016/j.hrtlng.2020.02.003. Epub 
      2020 Feb 14.