ArticleIntensive care medicine2015
Regional variation in critical care provision and outcome after high-risk surgery.
Article in Intensive care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis 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.
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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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Intensive care after vascular surgery: systematic review.The British journal of surgery · 2025Pooled it
- Patients With Dementia Undergoing High-Risk Inpatient Surgery Have Poor Outcomes.Journal of the American Geriatrics Society · 2025Article
- POSTOPERATIVE OUTCOME OF PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT AFTER ELECTIVE AND EMERGENCY LAPAROTOMY.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025Article
- Investigating the accuracy of adjusting for examiner differences in multi-centre Objective Structured Clinical Exams (OSCEs). A simulation study of video-based Examiner Score Comparison and Adjustment (VESCA).BMC medical education · 2024Article
- Hospital and regional variations in intensive care unit admission for patients with invasive mechanical ventilation.Journal of intensive care · 2024Article
- Case volume and specialization in critically ill emergency patients: a nationwide cohort study in Japanese ICUs.Journal of intensive care · 2024Article
- Intensive care utilisation after elective surgery in Australia and New Zealand: A point prevalence study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Observational
- Effects of the intermediate care unit on the oldest-old general surgical patients: a retrospective, pre- and postintervention study.Aging clinical and experimental research · 2021Article
- Post-operative intensive care: is it really necessary?Intensive care medicine · 2019Article
- Counting the cost of cancelled surgery: a system wide approach is needed.British journal of anaesthesia · 2018Article
- Intensive care utilization following major noncardiac surgical procedures in Ontario, Canada: a population-based study.Intensive care medicine · 2018Observational
- Current research priorities in perioperative intensive care medicine.Intensive care medicine · 2017Review
- Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries.Intensive care medicine · 2017Article
- Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.British journal of anaesthesia · 2016Article
- ICUs after surgery, mortality, and the Will Rogers effect.Intensive care medicine · 2015Article
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
purposeEvidence of variation in mortality after surgery may indicate preventable postoperative death. We sought to determine if regional differences in outcome were present in surgical patients admitted to critical care in the UK.
methodsWe extracted data on admission characteristics, case mix and outcome of all patients admitted to UK critical care units following surgery for the calendar year of 2009. We also used publicly held data on regional population, volume of surgery and bed provision. Multilevel regression analysis was used to adjust for the effects of case mix and regional critical care bed provision on acute hospital mortality.
resultsA total of 16,147 patients admitted to critical care following surgery were included in this analysis. Median odds ratio (MOR) was used to describe regional-level variance in acute hospital mortality. Significant variation was identified (MOR 1.14; 95% CI 1.07, 1.28) and persisted following adjustment for case mix (MOR 1.10; 95% CI 1.04, 1.25) and regional critical care bed provision (MOR 1.09; 95% CI 1.04, 1.24). Critical care bed utilisation (surgical critical care admissions per 100,000 surgical procedures) seemed to better explain this observation (MOR 1.03; 95% CI 1.00, 29.26) and was associated with statistically significant reduction in mortality (OR 0.91; 95% CI 0.85, 0.97; p = 0.01).
conclusionSignificant regional variation in hospital mortality for patients admitted to critical care following surgery was observed. Critical care bed utilisation seemed to better explain this observation and was associated with improved outcome.
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