Evidence map›Paper›PMID 31531716›Full record

ArticleIntensive care medicine2019

Near-simultaneous intensive care unit (ICU) admissions and all-cause mortality: a cohort study.

Markos G Kashiouris, Curtis N Sessler, Rehan Qayyum, Venu Velagapudi, Christos Stefanou, Rahul Kashyap, Niall Crowley, Craig Daniels, Kianoush Kashani

Abstract read
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In one paragraph

Article in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Development and validation of a deep learning model to predict the survival of patients in ICU.Journal of the American Medical Informatics Association : JAMIA · 2022
    Article
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Markos G KashiourisDivision of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Virginia Commonwealth University, Box 980050, Richmond, VA, 23298-0050, USA. mkashiouris@vcu.edu.ORCID http://orcid.org/0000-0001-5184-3030
Curtis N SesslerDivision of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Virginia Commonwealth University, Box 980050, Richmond, VA, 23298-0050, USA.
Rehan QayyumDepartment of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Venu VelagapudiDivision of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT, USA.
Christos StefanouThe Nepean Hospital, Sydney, NSW, 2751, Australia.
Rahul KashyapDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
Niall CrowleyDivision of Pulmonary Disease and Critical Care Medicine, Department of Medicine, Virginia Commonwealth University, Box 980050, Richmond, VA, 23298-0050, USA.
Craig DanielsDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Kianoush KashaniDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.

Funding

Mayo Clinic Center for Translational Science ActivitiesUL1TR000135 · NCATS · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 2012 to 2015
$41.2M
NIH HHS UL1TR000135
6 · The paper itself

Abstract

purposePrior studies have reported the adverse effects of strain on patient outcomes. There is a paucity of literature about a type of strain that may be caused by near-simultaneous intensive care unit (ICU) admissions. We hypothesized that when multiple admissions arrive nearly at the same time, the ICU teams are excessively strained, and this leads to unfavorable patient outcomes.

methodsThis is a retrospective cohort study of consecutive adult patients admitted to an academic medical ICU of a tertiary referral center over five consecutive years. Primary outcomes were the all-cause hospital and ICU mortality.

resultsWe enrolled 13,234 consecutive ICU admissions during the study period. One-fourth of the admissions had an elapsed time since the last admission (ETLA) of < 55 min. Near-simultaneous admissions (NSA) had on average, a higher unadjusted odds ratio (OR) of ICU death of 1.16 (95% CI 1-1.35, P = 0.05), adjusted 1.23 (95% CI 1.04-1.44, P = 0.01), unadjusted hospital death of 1.11 (95% CI 0.99-1.24, P = 0.06), adjusted 1.20 (95% 1.05-1.35, P = 0.004), and a lower adjusted OR of home discharge of 0.91 (95% CI 0.84-0.99, P = 0.04). NSA was associated with 0.16 (95% CI 0.04-0.29, P = 0.01) added days in the ICU. For each incremental unit increase of the logarithmic transformation of ETLA [log (ETLA in minutes)], the average adjusted hospital mortality OR incrementally decreased by an added average OR of 0.93 (95% CI 0.89‒0.97, P = 0.001).

conclusionOur results suggest that near-simultaneous ICU admissions (NSA) are frequent and are associated with a dose-dependent effect on mortality, length of stay, and odds of home versus nursing facility discharge.

Indexed as

Academic Medical CentersAdultAgedAPACHECohort StudiesFemaleHospitalizationHumansIntensive Care UnitsMaleMiddle AgedMortalityRetrospective StudiesTime FactorsMortalityStrainTime-pressureWorkload

Identifiers

PMID31531716

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Registered trials

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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.