BACKGROUND: The present survey aims to describe the intensive cardiac care unit organization and admission policies in Europe. METHODS: A total of 228 hospitals (61% academic) from 27 countries participated in this survey. In addition to the organizational aspects of the intensive cardiac care units, including classification of the intensive cardiac care unit levels, data on the admission diagnoses were gathered from consecutive patients who were admitted during a two-day period. Admission policies were evaluated by comparing illness severity with the intensive cardiac care unit level. Gross national income was used to differentiate high-income countries (n=13) from middle-income countries (n=14). RESULTS: A total of 98% of the hospitals had an intensive cardiac care unit: 70% had a level 1 intensive cardiac care unit, 76% had a level 2 intensive cardiac care unit, 51% had a level 3 intensive cardiac care unit, and 60% of the hospitals had more than one intensive cardiac care unit level. High-income countries tended to have more level 3 intensive cardiac care units than middle-income countries (55% versus 41%, p=0.07). A total of 5159 admissions were scored on illness severity: 63% were low severity, 24% were intermediate severity, and 12% were high severity. Patients with low illness severity were predominantly admitted to level 1 intensive cardiac care units, whereas patients with high illness severity were predominantly admitted to level 2 and 3 intensive cardiac care units. A policy mismatch was observed in 12% of the patients; some patients with high illness severity were admitted to level 1 intensive cardiac care units, which occurred more often in middle-income countries, whereas some patients with low illness severity were admitted to level 3 intensive cardiac care units, which occurred more frequently in high-income countries. CONCLUSION: More than one-third of the admitted patients were considered intermediate or high risk. Although patients with higher illness severity were mostly admitted to high-level intensive cardiac care units, an admission policy mismatch was observed in 12% of the patients; this mismatch was partly related to insufficient logistic intensive cardiac care unit capacity.

2nd Department of Medicine Charles University Czech Republic

Adult Intensive Care Unit Royal Brompton Hospital London

Clinical Center of Serbia Emergency Center Serbia

Cliniques Universitaires Saint Luc UCLouvain Belgium

Coimbra University Hospital Portugal

Department of Cardiology Aarhus University Hospital Denmark

Department of Cardiology Antwerp University Hospital Belgium

Department of Cardiology Konstantopouleio General Hospital Greece

Department of Cardiology Ospedale Maggiore Italy

Department of Cardiology Rigshospitalet Denmark

Department of Cardiology S Giovanni Evangelista Hospital Italy

Department of Cardiology University Hospital of Montpellier France

Department of Cardiology University of Opole Poland

Department of Cardiology University of Tartu Estonia

Department of Clinical Medicine University of Copenhagen Denmark

Department of Medical Sciences Uppsala Clinical Research Center Sweden

Division of Cardiology San Gerardo Hospital Italy

Faculty of Medicine Vilnius University Lithuania

Heart Center Leipzig University Hospital Germany

Heart Institute Holon Medical Center Israel

Hôpital Cantonal Fribourg Switzerland

Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona Spain

ICCO Clinics Transilvania University Romania

ICCU National Cardiology Hospital Bulgaria

Intensive Cardiac Care Unit Hospices Civils de Lyon France

National Heart Institution Egypt

North Estonia Medical Centre Estonia

Pauls Stradins Clinical University Hospital Latvia

PHO University Clinic of Cardiology Macedonia

Rambam Medical Health Center Israel

Red Cross General Hospital Greece

University College Hospital Ireland

University Hospital Centre Sisters of Mercy Croatia

References provided by Crossref.org