The Association of ICU Acuity With Outcomes of Patients at Low Risk of Dying

Critical Care Medicine
Kelly C VranasMeeta Prasad Kerlin

Abstract

Many ICU patients do not require critical care interventions. Whether aggressive care environments increase risks to low-acuity patients is unknown. We evaluated whether ICU acuity was associated with outcomes of low mortality-risk patients. We hypothesized that admission to high-acuity ICUs would be associated with worse outcomes. This hypothesis was based on two possibilities: 1) high-acuity ICUs may have a culture of aggressive therapy that could lead to potentially avoidable complications and 2) high-acuity ICUs may focus attention toward the many sicker patients and away from the fewer low-risk patients. Retrospective cohort study. Three hundred twenty-two ICUs in 199 hospitals in the Philips eICU database between 2010 and 2015. Adult ICU patients at low risk of dying, defined as an Acute Physiology and Chronic Health Evaluation-IVa-predicted mortality of 3% or less. ICU acuity, defined as the mean Acute Physiology and Chronic Health Evaluation IVa score of all admitted patients in a calendar year, stratified into quartiles. We used generalized estimating equations to test whether ICU acuity is independently associated with a primary outcome of ICU length of stay and secondary outcomes of hospital length of stay, hospital ...Continue Reading

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Citations

May 28, 2020·Intensive Care Medicine·Dylan W de LangeDavid Pilcher
Jun 4, 2021·Journal of Intensive Care Medicine·Saqib H BaigErika J Yoo
Jul 3, 2021·Sensors·Xina QuanAnoop Rao
Oct 12, 2021·British Journal of Community Nursing·Edward BakerGeraldine Lee

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