Evaluation of changes in vital signs prior to unplanned ICU admission

Abstract

[Purpose] We conducted this study to clarify the relationships of the first onset time and characteristics of abnormal vital signs with the reasons for unplanned ICU admission in the preceding 24 hr.

[Patients and methods] Three hundred and one adult patients with unplanned admission to the ICU during a 48-month period up to 2014 were enrolled in this study. Information on the time of occurrence and characteristics of the first abnormal vital signs that appeared within 24 hr before ICU admission was obtained from medical charts for patients in general wards.

[Results] The main reason for unplanned ICU admission in 54.9% of the enrolled patients was acute respiratory failure. There were no significant differences between the reasons for unplanned ICU admission and time of occurrence of abnormal vital signs. The durations from onset of abnormal vital signs to unplanned ICU admission were 8-13 hours regardless of the reasons for ICU admission. There were characteristic abnormal vital signs in the eligible patients; however, all of the abnormal vital signs were appeared regardless of the reasons for unplanned ICU admission.

[Conclusion] The results of our study suggest that we have sufficient time to prevent deterioration of patients with abnormal vital signs. Moreover, recognition of abnormal vital signs as urgent conditions of patients is important to prevent unplanned ICU admission through the education of nursing staff and the construction of track and trigger system.