Association between strained capacity and mortality among patients admitted to intensive care: A path-analysis modeling strategy

To evaluate the associations between strained ICU capacity and patient outcomes. 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 ≤1; occupancy ≥95%...

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Bibliographic Details
Published in:Journal of critical care 2018-02, Vol.43, p.81-87
Main Authors: Bagshaw, Sean M., Wang, Xioaming, Zygun, David A., Zuege, Dan, Dodek, Peter, Garland, Allan, Scales, Damon C., Berthiaume, Luc, Faris, Peter, Chen, Guanmin, Opgenorth, Dawn, Stelfox, Henry T.
Format: Article
Language:English
Subjects:
Capacity
Clinical outcomes
Comorbidity
Critical care
Health care policy
Health services
Hospitals
Illnesses
Intensive care
Intensive care unit
Mortality
Operations management
Organization
Patient admissions
Population
Quality
Ventilators
Workloads
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Summary:To evaluate the associations between strained ICU capacity and patient outcomes. 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 ≤1; occupancy ≥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. 12,265 admissions comprise the study cohort. Available beds ≤1 and occupancy ≥95% occurred for 22.3% and 17.0% of admissions. Lower bed availability was associated with higher APACHE II score (p
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2017.08.032