ICU PHYSICIANS ARE UNABLE TO ACCURATELY PREDICT LENGTH OF STAY AT ADMISSION: A PROSPECTIVE STUDY.
Int J Qual Health Care. 2015 Dec 13;
Authors: Nassar AP, Caruso P
OBJECTIVE: To evaluate the accuracy of prediction of intensive care unit length of stay made by physicians at patient admission.
DESIGN: Prospective cohort study.
SETTING: Three medical-surgical intensive care units in an oncology hospital.
PATIENTS: All patients admitted between January and December 2014.
MAIN OUTCOME MEASUREMENTS: Intensive care unit (ICU) length of stay was estimated by the physicians responsible for patient admission and categorized as <48 h, 2-5 days or more than 5 days. Agreement between predicted and actual intensive care unit length of stay was calculated.
RESULTS: A total of 2955 patients were admitted during the study period. Physicians accurately predicted ICU length of stay in 1557 (52.7%) admissions. ICU length of stay was underestimated in 864 (29.2%) and overestimated in 534 (18.1%) cases. Agreement between predicted and actual intensive care unit length of stay was poor (Kappa = 0.22) and not associated with physician characteristics. Predictions of an intensive care unit length of stay of >5 days were significantly less accurate than those of <48 h and of 2-5 days (31.1, 59.8 and 53.1%, respectively, P < 0.001).
CONCLUSIONS: The intensive care unit length of stay prediction in these oncological intensive care units is inaccurate and, ideally, should not be made at admission.
PMID: 26668104 [PubMed - as supplied by publisher]