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| Research article summary (published 29 Apr 2009): |
Intensive care unit occupancy and patient outcomes.
Full Abstract
PRINCIPLE: Although intensive care units (ICUs) with higher overall patient volume may achieve better outcomes than lower volume ICUs, there are few data on the effects of increasing patient loads on patients within the ICU. OBJECTIVES: To examine the association of ICU occupancy with the patient outcomes within the same ICU. METHODS: We examined 200,499 patients in 108 ICUs using the Acute Physiology and Chronic Health Evaluation IV database in 2002-2005. Daily census on the day of admission was determined for each patient and defined in relation to the mean census. We used conditional logistic regression to compare inpatient outcomes of patients admitted on high census days to those admitted in the same ICU on low census days. We controlled for severity of illness at the patient level using data on clinical, demographic, and physiologic variables on admission to the ICU. MEASUREMENTS AND MAIN RESULTS: Patients admitted on high census days had the same odds of inpatient mortality or transfer to another hospital as patients admitted on average or on low census days. These findings were robust to multiple alternative definitions of day of admission census and were confirmed in several subgroup analyses. CONCLUSIONS: The ICUs in this data are able to function as high reliability organizations. They are able to scale up their operations to meet the needs of a wide range of operating conditions while maintaining consistent patient mortality outcomes.
Author information
Author/s: Iwashyna, Theodore J (TJ); Kramer, Andrew A (AA); Kahn, Jeremy M (JM);
Affiliation: Department of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA. iwashyna(-atsign-)alumni.princeton.edu
Grants: 5T32HL007891 (Agency:NHLBI NIH HHS) ; K08-HL091249 (Agency:NHLBI NIH HHS)
Journal and publication information
Publication Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
Journal: Critical care medicine (Crit Care Med), published in United States. (Language: eng)
Reference: 2009-May; vol 37 (issue 5) : pp 1545-57
Dates: Created 2009/04/20; Completed 2009/05/05;
PMID: 19325466, status: MEDLINE (last retrieval date: 5/5/2009, IMS Date: 05 May 2009 00:00:00)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: Crit Care Med. 2009 May;37(5):1794-5. (PMID: 19373045)
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