Baseline Characteristics, Case Mix, and Outcomes of Patients Admitted to a Busy Urban Acute Medical Unit in Ireland

Background Acute medical admissions units (AMAUs) have been associated with decreased mortality and length of stay (LOS) for acute unscheduled hospital admissions. However, the needs and demands of patients admitted to AMAUs are constantly evolving in response to demographic changes and variations in the prevalence of illnesses. Method All patients admitted to the AMAU of a single-center hospital in Ireland in 2017, pre-COVID-19 era, were included in this study. Routine demographic information, including age, gender, date of admission, and duration of admission, and data regarding presenting complaints and immediate outcomes were collected using the hospital's patient administration system and electronic patient records. Results Of 3,037 admissions, 1,515 (49.9%) were female, the mean age was 61.7±20.2 years, and 971 (32.0%) were aged 75 years or older. The most common categories of admission were respiratory (719 patients, 23.7%), neurology (539 patients, 17.7%), falls and impaired functional status (314 patients, 10.3%), cardiovascular (278 patients, 9.5%), and clinical toxicology (209 patients, 6.9%). The most common reasons for admission were falls, syncope, and collapse (283 patients, 9.32%), lower respiratory tract infection (242 patients, 8%), exacerbation of chronic obstructive pulmonary disease (206 patients, 6.8%), drug overdose (112 patients, 3.7%), and urinary tract infections (106 patients, 3.5%). The median LOS was five days (IQR: 2-12), and 317 patients (10.4%) had a prolonged LOS (defined as 30 days or greater). Conclusion This study provides a detailed case mix in terms of presenting complaints and outcomes across all age groups. The data are of paramount importance regarding the provision of service, the ongoing structuring of acute hospitals, the mix of skills needed across AMAUs, and the guidance that training bodies provide to educate workers in acute medicine.