Cardiovascular third-year fellow Travis Moss, MD, and second-year internal medicine resident Eric Holland, MD, published a paper in the April 25th issue of the Journal of the American College of Cardiology that has important implications for how Cardiac Intensive Care Units are staffed and run.
Holland and Moss examined 1,042 admissions to UVA Hospital’s Cardiac Intensive Care Unit (CICU) over a 13-month period, performing multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes such as length of stay, hospital readmission and mortality. They found that one-half of all cases were marked by physiological failure of noncardiac organs (particularly lungs and kidneys), the most common diagnoses being acute respiratory failure, acute kidney injury, and sepsis. They were key contributors to prolonged length of stay and higher mortality.
In an editorial accompanying the study, authors Dudzinski and Januzzi remark that the Holland-Moss study “confirms what is widely known: CICU patients are a vulnerable lot, with poor physiological and cardiac reserve, and numerous comorbidities, and thus are less able to tolerate critical illness.”