Association between strained capacity and mortality among patients admitted to intensive care: A path-analysis modeling strategy
Association between strained capacity and mortality among patients admitted to intensive care: A path-analysis modeling strategy
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DOI：
10.1016/j.jcrc.2017.08.032
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发表时间：
2018-02-01
影响因子：
3.7
通讯作者：
Stelfox, Henry T.
中科院分区：
文献类型：
--
作者：
Bagshaw, Sean M.;Wang, Xioaming;Stelfox, Henry T.
目的：评估ICU容量紧张与患者预后之间的关系。方法：对加拿大艾伯塔省9个综合性ICU进行基于多中心人群的队列研究。通径分析模型被用来调查压力(可用床位=95%)和结果之间的直接和间接联系。结果：12,265例住院患者进入ICU，住院天数为12265例。可用床位=95%分别为22.3%和17.0%。床位利用率较低与APACHE II评分较高相关(p<；0.0001)。=95%的直接效果。压力与ICU住院时间的缩短有关，这主要是由更高的敏锐度引起的。结论：紧张的工作能力与ICU死亡率的增加有关，部分是通过更高的疾病敏锐度。今后的工作应同时考虑紧张对结果的直接和间接关系。(C)2017 Elsevier Inc.保留所有权利。
Purpose: To evaluate the associations between strained ICU capacity and patient outcomes.Methods: Multi-center population-based cohort study of nine integrated ICUs in Alberta, Canada. Path-analysis modeling was adopted to investigate direct and indirect associations between strain (available beds = 95%) and outcomes. Mixed-effects multivariate regression was used to measure the association between strain and acuity (APACHE II score), and both acuity and strain measures on ICU mortality and length of stay.Results: 12,265 admissions comprise the study cohort. Available beds = 95% occurred for 22.3% and 17.0% of admissions. Lower bed availability was associated with higher APACHE II score (p < 0.0001). The direct effect of = 95%. Strain was associated with shorter ICU stay, primarily mediated by greater acuity.Conclusions: Strained capacity was associated with increased ICU mortality, partly mediated through greater illness acuity. Future work should consider both the direct and indirect relationships of strain on outcomes. (C) 2017 Elsevier Inc. All rights reserved.