Effective use of regional intensive therapy units.

OBJECTIVE--To determine the effectiveness of regional intensive therapy units. DESIGN--Retrospective and prospective study of patients transferred to a regional intensive therapy unit over four years. SETTING--Glasgow regional intensive therapy unit. MAIN OUTCOME MEASURES--Severity of illness was assessed at the time of referral to the unit with the acute physiological and chronic health evaluation (APACHE) scoring system. Mortality was calculated. RESULTS--A significant association was found between increasing duration of illness before transfer and mortality, which was independent of the severity of illness. Mortality also varied depending on the referring hospital. CONCLUSIONS--When transfer of critically ill patients is required this should be done as early as possible to make best use of the services available. The mortality of patients transferred after 10 days casts doubt on whether further aggressive intensive therapy is appropriate.