Higher ICU Capacity Strain Is Associated With Increased Acute Mortality in Closed ICUs.

Critical Care Medicine
M Elizabeth WilcoxKathryn M Rowan

Abstract

To determine whether patients admitted to an ICU during times of strain, when compared with its own norm (i.e. accommodating a greater number of patients, higher acuity of illness, or frequent turnover), is associated with a higher risk of death in ICUs with closed models of intensivist staffing. We conducted a large, multicenter, observational cohort study. Multilevel mixed effects logistic regression was used to examine relationships for three measures of ICU strain (bed census, severity-weighted bed census, and activity-weighted bed census) on the day of admission with risk-adjusted acute hospital mortality. Pooled case mix and outcome database of adult general ICUs participating in the Intensive Care National Audit and Research Centre Case Mix Programme. The analysis included 149,310 patients admitted to 215 adult general ICUs in 213 hospitals in United Kingdom, Wales, and Northern Ireland. A relative lower strain in ICU capacity as measured by bed census on the calendar day (daytime hours) of admission was associated with decreased risk-adjusted acute hospital mortality (odds ratio, 0.94; 95% CI, 0.90-0.99; p = 0.01), whereas a nonsignificant association was seen between higher strain and increased acute hospital mortality...Continue Reading

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Citations

Jan 5, 2021·Journal of the American College of Emergency Physicians Open·Thomas B LeithBenjamin S Bassin
Dec 5, 2020·Journal of Patient Safety·M Abdulhadi AlaghaLaura C Myers
Jun 24, 2021·SAGE Open Nursing·Asaad Nasser Salim Al-Yahyai Rn BsnSathish Kumar Jayapal
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Apr 17, 2021·Critical Care Medicine·Alexander T TothVikramjit Mukherjee

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