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Article Dans Une Revue European Heart Journal: Acute Cardiovascular Care Année : 2020

Organization of intensive cardiac care units in Europe: Results of a multinational survey

1 Department of Cardiology, Antwerp University Hospital, Belgium. 2
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
4 Department of Cardiology, Ospedale Maggiore, Italy
5 Rambam Medical Health Center, Israel.
6 NCSR - National Center for Scientific Research "Demokritos"
7 UNISS - Università degli Studi di Sassari = University of Sassari [Sassari]
8 Department of Cardiology, University of Opole, Poland.
9 Heart Institute, Holon Medical Center, Israel.
10 Heart Center Leipzig, University Hospital, Germany
11 Red Cross General Hospital, Greece
12 Hospital de la Santa Creu i Sant Pau
13 Coimbra University Hospital, Portugal
14 Cliniques Universitaires Saint Luc, UCLouvain, Belgium.
15 Department of Medical Sciences, Uppsala Clinical Research Center, Sweden
16 ICCO Clinics, Transilvania University, Romania.
17 Pauls Stradins Clinical University Hospital, Latvia
18 Faculty of Medicine, Vilnius University, Lithuania
19 University Hospital Centre, Sisters of Mercy, Croatia
20 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
21 National Heart Institution, Egypt.
22 Department of Cardiology, Aarhus University Hospital, Denmark.
23 Teagasc - Teagasc - The Agriculture and Food Development Authority
24 University College Hospital, Ireland
25 Hôpital Cantonal Fribourg, Switzerland.
26 PHO University Clinic of Cardiology, Macedonia.
27 Clinical Center of Serbia, Emergency Center, Serbia.
28 ICCU, National Cardiology Hospital, Bulgaria
29 North Estonia Medical Centre
30 University of Tartu
31 Department of Cardiology, Rigshospitalet, Denmark
32 UCPH - University of Copenhagen = Københavns Universitet
33 Division of Cardiology, San Gerardo Hospital, Italy
34 Adult Intensive Care Unit, Royal Brompton Hospital, London.
35 Evaluation et modélisation des effets thérapeutiques
36 Intensive Cardiac Care Unit, Hospices Civils de Lyon, France.

Résumé

Background: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe. Methods: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries ($n$=13) from middle-income countries ($n$=14). Results: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, $p$=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries. Conclusion: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.
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Dates et versions

hal-02455056 , version 1 (03-08-2021)

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Mj Claeys, François Roubille, G Casella, R Zukermann, N. Nikolaou, et al.. Organization of intensive cardiac care units in Europe: Results of a multinational survey. European Heart Journal: Acute Cardiovascular Care, 2020, 9 (8), pp.993-1001. ⟨10.1177/2048872619883997⟩. ⟨hal-02455056⟩
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