ArticleJAMA internal medicine2017
Association of Intensive Care Unit Patient-to-Intensivist Ratios With Hospital Mortality.
Article in JAMA internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
39 citing papers in PubMed.
- Effect on Patient Safety of a Resident Physician Schedule without 24-Hour Shifts.The New England journal of medicine · 2020Trial
- The intensive care unit balancing act: integrated staffing models for better patient ratios.Critical care science · 2026Article
- Beyond Ratios: Rethinking Clinician Workload and Intensive Care Unit Outcomes.Annals of the American Thoracic Society · 2025Article
- Association of Intensive Care Unit Patient-to-Clinician Ratios with Mortality across Two U.S. Health Systems.Annals of the American Thoracic Society · 2025Article
- Consensus recommendations for the integration of critical care pharmacists on intensive care unit teams: Endorsed by the American Association of Critical-Care Nurses, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, Institute for Safe Medication Practices, and Society of Critical Care Medicine.Journal of the American College of Clinical Pharmacy : JACCP · 2025Article
- Article
- ICU capacity, ICU staffing, and postcardiotomy ECMO outcomes in China: a multilevel cross-sectional study.Critical care (London, England) · 2025Article
- Formal guidelines from an expert panel: intensive care unit medical staffing, organisation and working hours to improve quality of life at work in France.Annals of intensive care · 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
- Infection Prevention and Control Strategies According to the Type of Multidrug-Resistant Bacteria andAntibiotics (Basel, Switzerland) · 2024Review
- Data-driven coaching to improve statewide outcomes in CABG: before and after interventional study.International journal of surgery (London, England) · 2024Article
- Optimizing Pharmacist Team-Integration for ICU Patient Management: Rationale, Study Design, and Methods for a Multicentered Exploration of Pharmacist-to-Patient Ratio.Critical care explorations · 2023Article
- Staffing levels and hospital mortality in England: a national panel study using routinely collected data.BMJ open · 2023Observational
- Intensivist physician-to-patient ratios and mortality in the intensive care unit.Intensive care medicine · 2023Article
- Health and Well-Being of Intensive Care Unit Physicians: How to Ensure the Longevity of a Critical Specialty.Anesthesiology clinics · 2023Review
- Patient Outcomes and Unit Composition With Transition to a High-Intensity ICU Staffing Model: A Before-and-After Study.Critical care explorations · 2023Article
- Mortality analysis among sepsis patients in and out of intensive care units using the Japanese nationwide medical claims database: a study by the Japan Sepsis Alliance study group.Journal of intensive care · 2023Article
- Review
- Hospital characteristics associated with COVID-19 mortality: data from the multicenter cohort Brazilian Registry.Internal and emergency medicine · 2022Article
- SWEAT ICU-An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs.Critical care explorations · 2022Article
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: The patient-to-intensivist ratio (PIR) across intensive care units (ICUs) is not standardized and the association of PIR with patient outcome is not well established. Understanding the impact of PIR on outcomes is necessary to optimize senior medical staffing and deliver high-quality care. Objective: To test the hypotheses that: (1) there is significant variation in the PIR across ICUs and (2) higher PIRs are associated with higher hospital mortality for ICU patients. Design, Setting, and Participants: Retrospective cohort analysis of patients (≥16 years) admitted to ICUs staffed by a single intensivist during daytime hours in the United Kingdom from 2010 to 2013. Exposures: Patient-to-intensivist ratios, which we defined for each patient as the number of patients cared for by the intensivist each day averaged over the patient's stay. Main Outcomes and Measures: Using standard summary statistics, we evaluated PIR variation across ICUs. We used multivariable, mixed-effect, logistic regression analysis to evaluate the association between PIR and hospital mortality at ultimate discharge from acute hospital (primary outcome) and at ICU discharge. Finding: Among 49 686 adults in 94 ICUs, median age was 66 (interquartile range [IQR], 52-76) years, and 45.1% were women. The ultimate hospital mortality was 25.7%. The median PIR for patients was 8.5 (IQR, 6.9-10.8; full range, 1.0-23.5), and varied substantially among individual ICUs. The association between PIR and ultimate hospital mortality was U-shaped; there was a reduction in the odds of mortality associated with an increasing PIR up to 7.5 after which the odds of mortality increased again significantly (average patient mortality for lowest PIR, 22%; PIR of 7.5, 15%; highest PIR, 19%; P = .003). A similar U-shaped association was seen for PIR and mortality in the ICU (nadir of mortality at a PIR of 7.8, P < .001). Conclusions and Relevance: PIR varied across UK ICUs. The optimal PIR in this cohort of UK ICU patients was 7.5, with significantly increased ICU and hospital mortality above and below this ratio. The number of patients cared for by 1 intensivist may impact patient outcomes.
Indexed as
Identifiers
28118657What OpenQuestion holds
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.