[Impact of a monitoring unit in the medical department on patient outcome].

PURPOSE: Many hospitals have established monitoring units (MU) in their medical departments, with operating costs that are significantly lower than Intensive Care Units, but with no data on their effectiveness. We determined the outcome of patients, who were treated in a new MU during their hospitalization, compared with that of a control group. METHODS: We included all patients, who were admitted to the MU during a five months period. The control group consisted of patients, who were admitted to medical departments and did not stay in the MU during their hospitalization. Patients and controls were matched according to gender, age +/- 10 years, and need for mechanical ventilation. The main endpoint was the 28-day survival rate. RESULTS: There were minor differences between baseline characteristics of patients and controls. The patient cohort included a higher rate of acute renal failure (20/100, 20%) and chronic renal failure (23/100, 23%), compared to the control group (respectively, 10/100, 10%, p < 0.05 and 8/100, 8%, p < 0.05), and a higher rate of respiratory support (83/94, 82% and 72/99, 72%, p < 0.05). Contrarily, a GLasgow coma scale of 3-5 was found in 10/100 (10%) of MU patients and in 20/100 (20%) of control patients (p < 0.05). Despite these differences, there was no difference in predicted mortality score. Nevertheless, the observed survival rate of patients who stayed in the monitoring unit (76/100, 76%) was higher than that of the control group (64/100, 64%) (p < 0.05). CONCLUSIONS: The results of this pilot study indicate that a monitoring unit may contribute to improved survival.