Evidence map›Paper›PMID 27401184›Full record

Trial reportRespiratory research2016

Risk factors for mortality in patients admitted to intensive care units with pneumonia.

Guowei Li, Deborah J Cook, Lehana Thabane, Jan O Friedrich, Tim M Crozier, John Muscedere, John Granton, Sangeeta Mehta, Steven C Reynolds, Renato D Lopes and 4 more

Erratum issued Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Respiratory research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00182143 (PROphylaxis for ThromboEmbolism in Critical Care Trial), which is not on this map. Cited by 31 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 3 pooled it
3.8field-weighted citation impact, top 7% of its field
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.

NCT00182143 phase3completednot on this map

PROphylaxis for ThromboEmbolism in Critical Care Trial (PROTECT)

TypeinterventionalSponsorMcMaster UniversityRan2006 to 2010Enrolled3,659ConditionsCritical Illness, Deep Venous ThrombosisArmsLMWH (Fragmin, dalteparin), Unfractionated Heparin
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 60 citations in OpenAlex.

  1. Pooled it
  2. Clinical course and outcomes of critically ill patients with COVID-19 infection: a systematic review.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2021
    Pooled it
  3. Pooled it
  4. Clinical Impact of the BIOFIRE® FILMARRAY® Pneumonia Panel in the Veterans Affairs Healthcare System: A Difference-in-Differences Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 3 countries.

Guowei LiDepartment of Clinical Epidemiology & Biostatistics, McMaster University, 501-25 Charlton Avenue East, Hamilton, ON, L8N 1Y2, Canada. lig28@mcmaster.ca.
Deborah J CookDepartment of Clinical Epidemiology & Biostatistics, McMaster University, 501-25 Charlton Avenue East, Hamilton, ON, L8N 1Y2, Canada.
Lehana ThabaneDepartment of Clinical Epidemiology & Biostatistics, McMaster University, 501-25 Charlton Avenue East, Hamilton, ON, L8N 1Y2, Canada.
Jan O FriedrichInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Tim M CrozierIntensive Care Unit, Monash Medical Centre, Melbourne, VIC, Australia.
John MuscedereDepartment of Critical Care Medicine, Queens University Kingston, Kingston, ON, Canada.
John GrantonInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Sangeeta MehtaInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Steven C ReynoldsDivision of Critical Care, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Renato D LopesDuke Clinical Research Institute, Duke University, Durham, NC, USA.
Francois LauzierDepartment of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec, Canada.
Andreas P FreitagDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Mitchell A H LevineDepartment of Medicine, McMaster University, Hamilton, ON, Canada. levinem@mcmaster.ca.
PROTECT Investigators for the Canadian Critical Care Trials Group, and the Australian and New Zealand Intensive Care Society Clinical Trials Group
St. Joseph’s Healthcare Hamilton · CADuke University · USMcMaster University · CAMonash Medical Centre · AUMount Sinai Hospital · CAQueen's University · CASt. Michael's Hospital · CAUniversité Laval · CAUniversity Health Network · CAUniversity of British Columbia · CA

Funding

CIHR MCT78568
6 · The paper itself

Abstract

backgroundDespite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited.

methodsIn this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality.

resultsSix hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value < 0.001 for per-5 point increase), chronic heart failure (HR = 2.9, 95 % CI: 1.6 - 5.4, p-value = 0.001), and dialysis (time-dependent effect: HR = 2.7, 95 % CI: 1.3 - 5.7, p-value = 0.008). Higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value = 0.002 for per-5 point increase) and chronic heart failure (HR = 2.6, 95 % CI: 1.3 - 5.0, p-value = 0.004) were significantly related to risk of death in the ICU.

conclusionIn this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia.

trial registrationClinicalTrials.gov Identifier: NCT00182143 .

Indexed as

Hospital MortalityIntensive Care UnitsPatient AdmissionAgedAged, 80 and overAPACHEChi-Square DistributionDatabases, FactualFemaleHeart FailureHumansKaplan-Meier EstimateKidney DiseasesMaleMiddle AgedMultivariate AnalysisIntensive careMortalityPneumoniaRisk factor

Identifiers

PMID27401184
PMCPMC4940754
OpenAlexW2466765824

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.