{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:32:11Z","timestamp":1793197931727,"version":"4.5.0"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Indirect Intensive Care Unit (ICU) admissions, where patients admitted via the Emergency Department (ED) to a non\u2010critical care ward subsequently require ICU admission, may reflect missed recognition or underestimation of deterioration. This study aimed to:<\/jats:p>\n                    <jats:p>(1) Compare the frequency of indirect ICU admissions in an Australian hospital with international literature.<\/jats:p>\n                    <jats:p>(2) Describe this cohort according to ED care factors, reason for ICU admission, and hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Observational cohort study of indirect ICU admissions occurring within 24\u2009h of ED arrival between 1 June 2019 and 31 May 2022. Postoperative ICU admissions were excluded. Data were extracted from electronic medical records by two independent reviewers using a validated Data Collection Template (DCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 701 indirect ICU admissions, 148 met inclusion criteria. Indirect admissions accounted for 11.3% of all ED\u2010to\u2010ICU admissions. The most common reason for ICU admission was circulatory insufficiency, representing 43% of cases. Approximately half of patients were discussed with or reviewed by a Fellow of the Australasian College for Emergency Medicine (FACEM). 53% had normal observations (44% without supplemental oxygen); 20% were outside normal limits and a further 22% had altered calling criteria. Hospital mortality was 12.8%, higher than that of a reference Australian ICU population. Presentations between midnight and 08:00 were overrepresented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unplanned indirect ICU admissions occurred less frequently than reported internationally but were associated with high in\u2010hospital mortality. Given their association with adverse outcomes, quality improvement should focus on patients with abnormal vital signs, particularly circulatory insufficiency, and those presenting overnight.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70337","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:13:57Z","timestamp":1787904837000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Indirect\n                    <scp>ICU<\/scp>\n                    Admissions From an Australian Emergency Department: Risk Factors and Outcomes"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3677-0047","authenticated-orcid":false,"given":"Daniel","family":"McLennan","sequence":"first","affiliation":[{"name":"Emergency Department Northern Beaches Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliff","family":"Reid","sequence":"additional","affiliation":[{"name":"Emergency Department Northern Beaches Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhodri","family":"Martin","sequence":"additional","affiliation":[{"name":"Emergency Department Northern Beaches Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susannah","family":"Olive","sequence":"additional","affiliation":[{"name":"Emergency Department Northern Beaches Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0098-1705","authenticated-orcid":false,"given":"Guy","family":"Eslick","sequence":"additional","affiliation":[{"name":"The Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2003.005124"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005553"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)01754-4"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2019.1497"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51933"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b02dbb"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2016.05.009"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7148.1853"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70264-0"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70337","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1742-6723.70337","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:36:16Z","timestamp":1793194576000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/1742-6723.70337"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70337","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"assertion":[{"value":"2026-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70337"}}