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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The impact of hospital and ICU organizational factors on outcome in critically ill patients: Results from the Extended Prevalence of Infection in Intensive Care Study
Critical Care Medicine, Volume 43, No. 3, Year 2015
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Description
Objective: To investigate the impact of various facets of ICU organization on outcome in a large cohort of ICU patients from different geographic regions. Design: International, multicenter, observational study. Setting: All 1,265 ICUs in 75 countries that contributed to the 1-day point prevalence Extended Prevalence of Infection in Intensive Care study. Patients: All adult patients present on a participating ICU on the study day. Interventions: None. Measurements and Main Results: The Extended Prevalence of Infection in Intensive Care study included data on 13,796 adult patients. Organizational characteristics of the participating hospitals and units varied across geographic areas. Participating North American hospitals had greater availability of microbiologic examination and more 24-hour emergency departments than did the participating European and Latin American units. Of the participating ICUs, 82.9% were closed format, with the lowest prevalence among North American units (62.7%) and the highest in ICUs in Oceania (92.6%). The proportion of participating ICUs with 24-hour intensivist coverage was lower in North America than in Latin America (86.8% vs 98.1%, p = 0.002). ICU volume was significantly lower in participating ICUs from Western Europe, Latin America, and Asia compared with North America. In multivariable logistic regression analysis, medical and mixed ICUs were independently associated with a greater risk of in-hospital death. A nurse:patient ratio of more than 1:1.5 on the study day was independently associated with a lower risk of in-hospital death. Conclusions: In this international large cohort of ICU patients, hospital and ICU characteristics varied worldwide. A high nurse:patient ratio was independently associated with a lower risk of in-hospital death. These exploratory data need to be confirmed in large prospective studies that consider additional country-specific ICU practice variations. Copyright © 2015 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Authors & Co-Authors
Sakr, Yasser L.
Germany, Jena
Friedrich-schiller-universität Jena
Rhodes, Andrew
United Kingdom, London
St George's University Hospitals Nhs Foundation Trust
Ferguson, Niall D.
Canada, Toronto
University Health Network University of Toronto
Kleinpell, Ruth M.
United States, Chicago
Rush University Medical Center
Pickkers, Peter P.
Netherlands, Nijmegen
Radboud University Medical Center
Kuiper, Michaël A.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Netherlands, Leeuwarden
Medisch Centrum Leeuwarden
Lipman, Jeffrey
Australia, Brisbane
The University of Queensland
Vincent, Jean Louis
Belgium, Brussels
Université Libre de Bruxelles
Statistics
Citations: 160
Authors: 8
Affiliations: 9
Identifiers
Doi:
10.1097/CCM.0000000000000754
ISSN:
00903493
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Cohort Study
Exploratory Study
Study Approach
Quantitative