{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:00:05Z","timestamp":1785402005730,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T00:00:00Z","timestamp":1368489600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2013,5]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>The authors describe national trends in use, reasons for visit, most common diagnoses, and resource utilization in patients admitted to intensive care units (ICU<\/jats:styled-content>s) from hospital\u2010based emergency departments (ED<\/jats:styled-content>s) in the United States.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was an observational study using data from the National Hospital Ambulatory Care Survey, a nationally representative, weighted sample of U.S. hospital\u2010based ED<\/jats:styled-content>s from 2002 through 2009. The sample comprised a total of 4,267 patients aged 18\u00a0years or older admitted to the ICU<\/jats:styled-content> from the ED<\/jats:styled-content>, which represent over 14.5 million ED<\/jats:styled-content> encounters from 2002 through 2009.<\/jats:p><\/jats:sec>Results<\/jats:title>Over the study period, ICU<\/jats:styled-content> admissions from ED<\/jats:styled-content>s increased from 2.79 million in 2002\/2003, to 4.14 million in 2008\/2009, an absolute increase of 48.8% and a mean biennial increase of 14.2%. By comparison, overall ED<\/jats:styled-content> visits increased a mean of 5.8% per biennial period. The three most common diagnoses for ICU<\/jats:styled-content> admissions were unspecified chest pain, congestive heart failure, and pneumonia. Utilization rates of most tests and services delivered to patients admitted to the ICU<\/jats:styled-content> from the ED<\/jats:styled-content> increased, with the largest increase occurring in computed tomography (CT<\/jats:styled-content>) and magnetic resonance imaging (MRI<\/jats:styled-content>), which increased from 16.8% in 2002\/2003 to 37.4% in 2008\/2009, a 6.9% mean biennial increase. Across all\u00a0years, mean ED<\/jats:styled-content> length of stay (LOS<\/jats:styled-content>) for ICU<\/jats:styled-content> admissions was 304 minutes (95% confidence interval [CI<\/jats:styled-content>]\u00a0=\u00a0286 to 323 minutes), and mean hospital LOS<\/jats:styled-content> was 6.6\u00a0days (95% CI<\/jats:styled-content>\u00a0=\u00a06.2 to 7.0\u00a0days). There was no significant change in either mean ED<\/jats:styled-content> or hospital LOS<\/jats:styled-content> over the study period.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Intensive care unit admissions from ED<\/jats:styled-content>s are increasing at a greater rate than both population growth and overall ED<\/jats:styled-content> visits. ED<\/jats:styled-content> resource use, specifically advanced diagnostic imaging, has increased markedly among ICU<\/jats:styled-content> admissions. While mean ED<\/jats:styled-content> and hospital LOS<\/jats:styled-content> have not changed significantly, the mean ICU<\/jats:styled-content> admission spends over 5\u00a0hours in the ED<\/jats:styled-content> prior to transfer to an ICU<\/jats:styled-content> bed. A greater emphasis on the ED<\/jats:styled-content>\u2013ICU<\/jats:styled-content> interface and critical care delivered in the ED<\/jats:styled-content> may be warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12134","type":"journal-article","created":{"date-parts":[[2013,5,14]],"date-time":"2013-05-14T15:59:48Z","timestamp":1368547188000},"page":"479-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["National Growth in Intensive Care Unit Admissions From Emergency Departments in the United States from 2002 to 2009"],"prefix":"10.1111","volume":"20","author":[{"given":"Peter M.","family":"Mullins","sequence":"first","affiliation":[{"name":"Department of Health Policy George Washington University School of Public Health and Health Sciences Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munish","family":"Goyal","sequence":"additional","affiliation":[{"name":"and the Departments of Emergency Medicine and Internal Medicine Division of Pulmonary Critical Care and Respiratory Services MedStar Washington Hospital Center Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse M.","family":"Pines","sequence":"additional","affiliation":[{"name":"Department of Health Policy George Washington University School of Public Health and Health Sciences Washington DC"},{"name":"Department of Emergency Medicine George Washington University School of Public Health and Health Sciences Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b090d0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4065\/81.7.896"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000227652.08185.A4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-1007"},{"key":"e_1_2_7_6_1","unstructured":"Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services.100% MEDPAR Inpatient Hospital National Data for Fiscal Year2010. 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