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Yes- mind the gap!
BMC Anesthesiology volume 21, Article number: 42 (2021)
We totally agree with Deana and Colleagues that missing intermediate care 1) might be an explanation for unexpected unfavorable outcome and 2) strengthening of intermediate care has the potential to lower this high rate of unfavorable outcome after ICU discharge. Yes- mind the gap!
We want to thank Deana and Colleagues for their interesting comment on our study .
The authors discussed our study and they point out a very important issue: patients after critical illness might benefit from a “soft transition” to an Intermediate Care Unit (IMCU) rather than a normal ward. They explain very conclusively the importance to allocate patients to the resources they need regarding, nursing, monitoring, physicians and therapists. Unfortunately our study could not give any information on intermediate care unit usage, as this information is not part of the trauma registry. We ourselves already tried to investigate the value of IMCU in another setting, a large german intensive care registry , and we totally agree with Deana and Colleagues that missing intermediate care 1) might be an explanation for unexpected unfavorable outcome and 2) strengthening of intermediate care has the potential to lower this high rate of unfavorable outcome after ICU discharge. Yes- mind the gap!
Availability of data and materials
Intensive care unit
Intermediate care unit
Hamsen U, Drotleff N, Lefering R, Gerstmeyer J, Schildhauer TA, Waydhas C, TraumaRegister DGU. Mortality in severely injured patients: nearly one of five non-survivors have been already discharged alive from ICU. BMC Anesthesiol. 2020;20(1):243.
Hamsen U, Lefering R, Fisahn C, Schildhauer TA, Waydhas C. Workload and severity of illness of patients on intensive care units with available intermediate care units: a multicenter cohort study. Minerva Anestesiol. 2018;84(8):938–45.
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Hamsen, U., Drotleff, N., Lefering, R. et al. Yes- mind the gap!. BMC Anesthesiol 21, 42 (2021). https://doi.org/10.1186/s12871-021-01250-8