Observational studyCritical care (London, England)2014
Hospital mortality of adults admitted to Intensive Care Units in hospitals with and without Intermediate Care Units: a multicentre European cohort study.
Observational study in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01422070 (A Multi-centre European Observational Study to Assess Whether Patients Admitted to the ICUs With Availability of Intermediate Care Unit), which is not on this map. Cited by 94 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Multi-centre European Observational Study to Assess Whether Patients Admitted to the ICUs With Availability of Intermediate Care Unit (IMCU) Have Lower Hospital Mortality Than Those Admitted to the ICUs Without Availability of IMCU
Who cites it
94 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence and Risk Factors Associated With ICU Mortality in Ethiopia: A Systemic Review and Meta-Analysis.Nursing open · 2025Pooled it
- Association of Arterial Hyperoxia With Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Integrating Paediatric Intermediate Care Units Into Tiered Care Systems: A Narrative Review and Italian Perspective.Acta paediatrica (Oslo, Norway : 1992) · 2026Review
- Patterns of medical intermediate care unit use in critically ill very old patients in France.European geriatric medicine · 2026Article
- Admission Biomarkers as Predictors of Mortality in Comatose Patients in the Intensive Care Unit: A Retrospective Pilot Study.Diagnostics (Basel, Switzerland) · 2026Article
- Outcomes of patients with hypertensive emergency managed in intensive vs intermediate care settings: a multihospital retrospective cohort study.Annals of the American Thoracic Society · 2026Observational
- Article
- Nutritional-inflammatory-metabolic indices associated with in-hospital mortality in acute kidney injury patients undergoing continuous renal replacement therapy: dose-response analysis and machine learning-based risk stratification.Frontiers in nutrition · 2026Article
- Intensive care nurses' perceptions of good death and end-of-life care attitudes and behaviors: a descriptive and correlational quantitative study.BMC palliative care · 2025Article
- Intermediate care units: an effective alternative to reduce intensive care unit admissions-a prospective cohort study.Internal and emergency medicine · 2025Observational
- Intermediate Care Units in Europe and Italy: A Review of Structure, Outcomes, and Policy Implications for Internal Medicine.Journal of clinical medicine · 2025Review
- Predictors of Mortality in Medical ICU Patients: A Retrospective Study in a Tertiary Care Center in Jordan.Journal of clinical medicine · 2025Article
- Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study.Annals of intensive care · 2025Article
- Outcomes and cost-effectiveness of intermediate care units for patients discharged from the intensive care unit: a nationwide retrospective observational study.Critical care (London, England) · 2025Observational
- In-hospital mortality of patients admitted to the intermediate care unit in hospitals with and without an intensive care unit: a nationwide inpatient database study.Critical care (London, England) · 2025Article
- Diagnoses and critical care outcomes in a rural Tanzanian high dependency unit: A prospective cohort study.PloS one · 2025Article
- Evaluating treatment and care outcomes for neuromuscular diseases in a pediatric intermediate care setting.Frontiers in pediatrics · 2025Article
- Data-driven modelling of IRCU patient flow during the COVID-19 pandemic.Computational and structural biotechnology journal · 2025Article
- Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis.Critical care (London, England) · 2024Article
- Machine Learning Identification of Modifiable Predictors of Patient Outcomes After Transcatheter Aortic Valve Replacement.JACC. Advances · 2024Article
34 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of the study was to assess whether adults admitted to hospitals with both Intensive Care Units (ICU) and Intermediate Care Units (IMCU) have lower in-hospital mortality than those admitted to ICUs without an IMCU.
methodsAn observational multinational cohort study performed on patients admitted to participating ICUs during a four-week period. IMCU was defined as any physically and administratively independent unit open 24 hours a day, seven days a week providing a level of care lower than an ICU but higher than a ward. Characteristics of hospitals, ICUs and patients admitted to study ICUs were recorded. The main outcome was all-cause in-hospital mortality until hospital discharge (censored at 90 days).
resultsOne hundred and sixty-seven ICUs from 17 European countries enrolled 5,834 patients. Overall, 1,113 (19.1%) patients died in the ICU and 1,397 died in hospital, with a total of 1,397 (23.9%) deaths. The illness severity was higher for patients in ICUs with an IMCU (median Simplified Acute Physiology Score (SAPS) II: 37) than for patients in ICUs without an IMCU (median SAPS II: 29, P <0.001). After adjustment for patient characteristics at admission such as illness severity, and ICU and hospital characteristics, the odds ratio of mortality was 0.63 (95% CI 0.45 to 0.88, P = 0.007) in favour of the presence of IMCU. The protective effect of the IMCU was absent in patients who were admitted for basic observation, for example, after surgery (odds ratio 1.15, 95% CI 0.65 to 2.03, P = 0.630) but was strong in patients admitted to an ICU for other reasons (odds ratio 0.54, 95% CI 0.37 to 0.80, P = 0.002).
conclusionsThe presence of an IMCU in the hospital is associated with significantly reduced adjusted hospital mortality for adults admitted to the ICU. This effect is relevant for the patients requiring full intensive treatment.
trial registrationClinicaltrials.gov NCT01422070. Registered 19 August 2011.
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