Evidence map›Paper›PMID 26975737›Full record

ArticleJournal of critical care2016

The organizational structure of an intensive care unit influences treatment of hypotension among critically ill patients: A retrospective cohort study.

M Dustin Boone, Jennifer Massa, Ariel Mueller, Sayuri P Jinadasa, Joon Lee, Rishi Kothari, Daniel J Scott, Julie Callahan, Leo Anthony Celi, Michele R Hacker

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of critical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Unilateral Vocal Fold Immobility After Prolonged Endotracheal Intubation.JAMA otolaryngology-- head & neck surgery · 2020
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

M Dustin BooneDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Jennifer MassaDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Ariel MuellerDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Sayuri P JinadasaDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA.
Joon LeeDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA; School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Rishi KothariMount Sinai School of Medicine, New York City, NY.
Daniel J ScottDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA.
Julie CallahanDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA.
Leo Anthony CeliDivision of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA.
Michele R HackerHarvard Medical School, Boston, MA; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: mhacker@bidmc.harvard.edu.

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
Critical Care Informatics: Ethical considerations around the use and sharing of health-related dataR01EB017205 · NIBIB · MASSACHUSETTS INSTITUTE OF TECHNOLOGY · PI CELI, LEO ANTHONY G, MARK, ROGER GREENWOOD · 2014 to 2021
$3.8M
NCATS NIH HHS UL1 TR001102NIBIB NIH HHS R01 EB017205
6 · The paper itself

Abstract

purposePrior studies report that weekend admission to an intensive care unit is associated with increased mortality, potentially attributed to the organizational structure of the unit. This study aims to determine whether treatment of hypotension, a risk factor for mortality, differs according to level of staffing.

methodsUsing the Multiparameter Intelligent Monitoring in Intensive Care database, we conducted a retrospective study of patients admitted to an intensive care unit at Beth Israel Deaconess Medical Center who experienced one or more episodes of hypotension. Episodes were categorized according to the staffing level, defined as high during weekday daytime (7 am-7 pm) and low during weekends or nighttime (7 pm-7 am).

resultsPatients with a hypotensive event on a weekend were less likely to be treated compared with those that occurred during the weekday daytime (P = .02). No association between weekday daytime vs weekday nighttime staffing levels and treatment of hypotension was found (risk ratio, 1.02; 95% confidence interval, 0.98-1.07).

conclusionPatients with a hypotensive event on a weekend were less likely to be treated than patients with an event during high-staffing periods. No association between weekday nighttime staffing and hypotension treatment was observed. We conclude that treatment of a hypotensive episode relies on more than solely staffing levels.

Indexed as

Critical IllnessAfter-Hours CareAgedAged, 80 and overCohort StudiesDatabases, FactualFemaleHospital MortalityHumansHypotensionIntensive Care UnitsMaleMiddle AgedOdds RatioPersonnel Staffing and SchedulingRetrospective StudiesCritical careHospital medical staffHypotensionIntensive care unitResuscitation

Identifiers

PMID26975737
PMCPMC4842333

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.