Telemedicine Intervention Improves ICU Outcomes

Abstract EN

Telemedicine for the intensive care unit (Tele-ICU) was founded as a means of delivering the clinical expertise of intensivists located remotely to hospitals with inadequate access to intensive care specialists.

This was a retrospective pre- and postintervention study of adult patients admitted to a community hospital ICU.

The patients in the preintervention period (n=630) and during the Tele-ICU period (n=2193) were controlled for baseline characteristics, acute physiologic scores (APS), and acute physiologic and health evaluation (APACHE IV) scores.

Mean APS scores were 37.1 (SD, 22.8) and 37.7 (SD, 19.4) (P=0.56), and mean APACHE IV scores were 49.7 (SD, 24.8) and 50.4 (SD, 21.0) (P=0.53), respectively.

ICU mortality was 7.9% during the preintervention period compared with 3.8% during the Tele-ICU period (odds ratio (OR) = 0.46, 95% confidence interval (CI), 0.32–0.66, P<0.0001).

ICU LOS in days was 2.7 (SD, 4.1) compared with 2.2 (SD, 3.4), respectively (hazard ratio (HR) = 1.16, 95% CI, 1.00–1.40, P=0.01).

Implementation of Tele-ICU intervention was associated with reduced ICU mortality and ICU LOS.

This suggests that there are benefits of a closed Tele-ICU intervention beyond what is provided by daytime bedside physicians.