Irish national ICU audit interim report 2019

This report provides a comprehensive overview of activity and outcomes during 2019 in Critical Care Units (ICUs and HDUs) which undertake 88% of critical care in HSE-funded hospitals. The report contains data from four hospitals which were not included in previous reports, including Cork University Hospital, one of the largest hospitals in the country. The data in this report are consistent with data from 2018, with no major changes in activity or outcomes. Units are very busy and have high bed occupancy rates. Patients are very ill, with high scores for illness severity and requiring high levels of organ support compared to the UK. The larger referral centres were under particular pressure in 2019 with very ill patients and high occupancy levels. Outcomes were acceptable, with the overall national risk-adjusted mortality rate exactly at the expected level. There were sporadic outlier data for QIs which indicated shortages of ICU beds, e.g. delayed admission and early discharge. Hospitals have responded to these outlier findings and proposed actions to address the problem, usually by expanding ICU bed capacity. This is the first INICUA report to include a section on admissions of patients who were pregnant or recently pregnant. Outcomes were good in these patients with just 2 deaths, both related to serious underlying disease. In summary, Irish ICUs are very busy but are managing to provide high-quality care with good outcomes. However, there is little reserve capacity in the system.