ArticleIntensive care medicine2014
Is the volume of mechanically ventilated admissions to UK critical care units associated with improved outcomes?
Article in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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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
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative evidence-synthesis.The Cochrane database of systematic reviews · 2016Pooled it
- The Volume-Outcome Relationship in Critical Care: A Systematic Review and Meta-analysis.Chest · 2015Pooled it
- Can treating critically-ill haematological malignancy patients in a separate intensive care unit decrease intensive care unit mortality?Turkish journal of medical sciences · 2021Article
- Time spent in prior hospital stay and outcomes for ventilator patients in long-term acute care hospitals.BMC pulmonary medicine · 2021Article
- Adapting hospital capacity to meet changing demands during the COVID-19 pandemic.BMC medicine · 2020Article
- The Association Between Acute Respiratory Distress Syndrome Hospital Case Volume and Mortality in a U.S. Cohort, 2002-2011.Critical care medicine · 2018Article
- A mixed-methods systematic review protocol to examine the use of physical restraint with critically ill adults and strategies for minimizing their use.Systematic reviews · 2016Article
- PICU Volume and Outcome: A Severity-Adjusted Analysis.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Article
- The association between ICU level of care and mortality in the Netherlands.Intensive care medicine · 2015Article
- Effect of cardiogenic shock hospital volume on mortality in patients with cardiogenic shock.Journal of the American Heart Association · 2015Article
- Should mechanical ventilation care be centralized and should we thus transfer all ventilated patients to high volume units? Take a breath first.Intensive care medicine · 2014Article
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3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unknown whether a volume-outcome relationship exists for mechanically ventilated admissions to UK critical care units. This study was conducted to evaluate the volume-outcome relationship for mechanically ventilated admissions to adult, general critical care units in the UK with a view to informing policy, service delivery and organisation of specialist, advanced respiratory care.
methodsA retrospective cohort study using data from the Case Mix Programme Database was conducted. The primary exposure of interest was annual volume (absolute number) of mechanically ventilated admissions per critical care unit per year. The primary outcome was ultimate acute hospital mortality. A multivariable analysis was performed to assess the relationship between annual volume and outcome while adjusting for a priori selected confounders. Two interaction tests were performed. The first interaction test was between annual volume and admission type and the second between annual volume and initial acute severity of respiratory failure. Sensitivity analysis excluding volume outlier units and using restricted cubic splines to model volume was also performed.
resultsAfter adjusting for confounding, there was a significant relationship between annual volume and ultimate acute hospital mortality (p < 0.02). The first interaction test revealed a strong interaction between annual volume and admission type, with a more pronounced volume-outcome relationship for non-surgical admissions (p < 0.001). The second interaction test between annual volume and initial acute severity of respiratory failure was not statistically significant (p = 0.12). The analysis using restricted cubic splines demonstrated a similar graphical relationship but the results were not statistically significant (p = 0.87).
conclusionsA volume-outcome relationship was demonstrated for mechanically ventilated admissions to adult, general critical care units in the UK. The relationship is sensitive to the modelling approach used.
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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.