Admissions to intensive care units in England peak in December and are at their lowest in February, latest figures have shown. Admission rates in December are 30% higher than in the quietest month, said the researchers, who analysed data on 16<thin>355 critically ill patients admitted to five NHS critical care units during an eight year period. They also found that there has been an increase in admissions equivalent to an annual rise of 6.6%. In a report of the study (Anaesthesia 2001;56:1136-40), the team said that a summer peak in admissions during June to August appeared to be increasing over time. They say that the cause of this peak should be the focus of further research. The study was designed to quantify any seasonal changes and was based on data collected from five adjacent critical care units in the eastern region of England: Norfolk and Norwich Hospital; Addenbrooke's Hospital, Cambridge; Ipswich Hospital, Queen Elizabeth II Hospital, King's Lynn; and West Suffolk Hospital, Bury St Edmunds. "Intensive care physicians perceive that there is seasonal variation in the number of admissions to critical care services. There is, however, little published evidence to support this belief," said the report. It said that the figures may be an underestimate because the study included only patients who were admitted to an intensive care unit, and some hospitals in the survey ventilated patients in other areas. In one hospital, 10 critically ill adult patients were being ventilated outside the general critical care unit. The data also showed that the seasonal peaks and troughs in activity followed the same pattern in all of the units, a finding that may have implications for the transfer of patients.
The report said: "The National Expert Group on Intensive Care Medicine recently recommended that hospital networks and transfer groups be set up in order to facilitate the transfer of patients between adjacent hospitals in times of pressure on beds.
"Our results show that if one hospital has a bed crisis, it is extremely likely that the intensive care units at the adjacent hospitals will also be full, and so transfer between them may be impossible." It said that the strategy proposed in the Department of Health's report Comprehensive Critical Care "may not be an all-embracing solution at times of global pressure on beds."
It added, "It is crucial that there are enough intensive care beds for those that need them, but it is also important not to waste this valuable resource. There should be further research into the causes of seasonal variation in demand for intensive care beds. In this way, better planning of critical care services for the future may be possible." Comprehensive Critical Care is available at www.doh.gov.uk/compcritcare/
