ArticleCritical care medicine2019
Hospital Mechanical Ventilation Volume and Patient Outcomes: Too Much of a Good Thing?
Article in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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.
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Who cites it
7 citing papers in PubMed.
- Lactate to albumin ratio predicts one year mortality in ICU patients receiving invasive mechanical ventilation.Scientific reports · 2026Article
- Telemedicine critical care availability and outcomes among mechanically ventilated patients.Journal of critical care · 2024Article
- Relationship between institutional ventilated COVID-19 case volume and in-hospital death: A multicenter cohort study.PloS one · 2023Observational
- Relationship between institutional intensive care volume prior to the COVID-19 pandemic and in-hospital death in ventilated patients with severe COVID-19.Scientific reports · 2022Observational
- The association between cardiac intensive care unit mechanical ventilation volumes and in-hospital mortality.European heart journal. Acute cardiovascular care · 2021Article
- Trends in Post-Acute Care Use after Admissions for Sepsis.Annals of the American Thoracic Society · 2020Article
- Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors.BMC pediatrics · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesPrior studies investigating hospital mechanical ventilation volume-outcome associations have had conflicting findings. Volume-outcome relationships within contemporary mechanical ventilation practices are unclear. We sought to determine associations between hospital mechanical ventilation volume and patient outcomes.
designRetrospective cohort study.
settingThe California Patient Discharge Database 2016. PATIENTS: Adult nonsurgical patients receiving mechanical ventilation.
interventionsThe primary outcome was hospital death with secondary outcomes of tracheostomy and 30-day readmission. We used multivariable generalized estimating equations to determine the association between patient outcomes and hospital mechanical ventilation volume quartile. MEASUREMENTS AND MAIN
resultsWe identified 51,689 patients across 274 hospitals who required mechanical ventilation in California in 2016. 38.2% of patients died in the hospital with 4.4% receiving a tracheostomy. Among survivors, 29.5% required readmission within 30 days of discharge. Patients admitted to high versus low volume hospitals had higher odds of death (quartile 4 vs quartile 1 adjusted odds ratio, 1.40; 95% CI, 1.17-1.68) and tracheostomy (quartile 4 vs quartile 1 adjusted odds ratio, 1.58; 95% CI, 1.21-2.06). However, odds of 30-day readmission among survivors was lower at high versus low volume hospitals (quartile 4 vs quartile 1 adjusted odds ratio, 0.77; 95% CI, 0.67-0.89). Higher hospital mechanical ventilation volume was weakly correlated with higher hospital risk-adjusted mortality rates (ρ = 0.16; p = 0.008). These moderately strong observations were supported by multiple sensitivity analyses.
conclusionsContrary to previous studies, we observed worse patient outcomes at higher mechanical ventilation volume hospitals. In the setting of increasing use of mechanical ventilation and changes in mechanical ventilation practices, multiple mechanisms of worse outcomes including resource strain are possible. Future studies investigating differences in processes of care between high and low volume hospitals are necessary.
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