ArticleIntensive care medicine2004
Volume of activity and occupancy rate in intensive care units. Association with mortality.
Article in Intensive care medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Association Between Hospital Capacity Strain and Inpatient Outcomes in Highly Developed Countries: A Systematic Review.Journal of general internal medicine · 2017Pooled it
- Does patient volume affect clinical outcomes in adult intensive care units?Intensive care medicine · 2012Pooled it
- Assessing the performance of Portuguese public hospitals before and during COVID-19 outbreak, with optimistic and pessimistic benchmarking approaches.Health care management science · 2025Article
- Simulating the effects of reducing transfer latency from the intensive care unit on intensive care unit bed utilization in a Korean Tertiary Hospital.Acute and critical care · 2025Article
- Factors Influencing Morbidity and Mortality Rates in Tertiary Intensive Care Units in Turkey: A Retrospective Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- Creation and Expansion of a Mixed Patient Intermediate Care Unit to Improve ICU Capacity.Critical care explorations · 2023Article
- Impact of institutional case volume on intensive care unit mortality.Acute and critical care · 2023Article
- Relationship between institutional ventilated COVID-19 case volume and in-hospital death: A multicenter cohort study.PloS one · 2023Observational
- Relationship between institutional intensive care volume prior to the COVID-19 pandemic and in-hospital death in ventilated patients with severe COVID-19.Scientific reports · 2022Observational
- Intensive Care Unit Occupancy in Japan, 2015-2018: A Nationwide Inpatient Database Study.Journal of epidemiology · 2022Article
- Mortality of Mechanically Ventilated COVID-19 Patients in Traditional versus Expanded Intensive Care Units in New York.Annals of the American Thoracic Society · 2022Article
- Predictors of Delayed Recognition of Critical Illness in Emergency Department Patients and Its Effect on Morbidity and Mortality.Journal of intensive care medicine · 2022Article
- Managing admission and discharge processes in intensive care units.Health care management science · 2021Article
- The association between mechanical ventilator compatible bed occupancy and mortality risk in intensive care patients with COVID-19: a national retrospective cohort study.BMC medicine · 2021Observational
- Using COVID-19 mortality to select among hospital plant capacity models: An exploratory empirical application to Hubei province.Technological forecasting and social change · 2021Article
- Article
- Lessons learned and new directions regarding Discharge Direct from Adult Intensive Care Units Sent Home (DISH): A narrative review.Journal of the Intensive Care Society · 2019Review
- Machine Learning and Mobile Health Monitoring Platforms: A Case Study on Research and Implementation Challenges.Journal of healthcare informatics research · 2018Article
- Mortality of adult intensive care units in Turkey using the APACHE II and SOFA systems (outcome assessment in Turkish intensive care units).Archives of medical science : AMS · 2018Article
- Operations research in intensive care unit management: a literature review.Health care management science · 2018Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMortality after many procedures is lower in centers where more procedures are done. It is controversial whether this is true for intensive care units, too. We examined the relationship between the volume of activity of intensive care units (ICUs) and mortality by a measure of risk-adjusted volume of activity specific for ICUs.
designProspective, multicenter, observational study.
settingEighty-nine ICUs in 12 European countries. PATIENTS: During a 4-month study period, 12,615 patients were enrolled.
interventionsDemographic and clinical statistics, severity at admission and a score of nursing complexity and workload were collected.
resultsTotal volume of activity was defined as the number of patients admitted per bed per year, high-risk volume as the number of high-risk patients admitted per bed per year (selected combining of length of stay and severity of illness). A multi-step risk-adjustment process was planned. ICU volume corresponding both to overall [odds ratio (OR) 0.966] and 3,838 high-risk (OR 0.830) patients was negatively correlated with mortality. Relative mortality decreased by 3.4 and 17.0% for every five extra patients treated per bed per year in overall volume and high-risk volume, respectively. A direct relationship was found between mortality and the ICU occupancy rate (OR 1.324 and 1.351, respectively).
conclusionsIntensive care patients, whatever their level of risk, are best treated where more high-risk patients are treated. Moreover, the higher the ICU occupancy rate, the higher is the mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.