ArticleIntensive care medicine2020
Hospital-level variation in the development of persistent critical illness.
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 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
19 citing papers in PubMed.
- The Challenges of Prognosticating Persistent Critical Illness: A Qualitative Study.CHEST critical care · 2026Article
- Article
- Rinaldo Bellomo and the evolution of critical care survivorship.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Article
- Accuracy of Intensivist Prognostications of Deterioration within the Intensive Care Unit and Development of Persistent Critical Illness: A Prospective Cohort Study.Annals of the American Thoracic Society · 2025Article
- Timing of onset of persistent critical illness in Japan: a nationwide registry study.The Lancet regional health. Western Pacific · 2025Article
- Implementation of a Quality Improvement Tool "Recover25" to Guide the Care of Patients Experiencing Prolonged Critical Illness: A Mixed-Method Feasibility Study.Critical care explorations · 2025Article
- Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice.Critical care (London, England) · 2024Article
- Codesign of a Quality Improvement Tool for Adults With Prolonged Critical Illness: A Modified Delphi Consensus Study.Critical care explorations · 2024Article
- Interhospital variation in the non-operative management of uncomplicated appendicitis in adults.Surgery open science · 2024Article
- Article
- Daily Oxygenation Support for Patients Hospitalized With SARS-CoV-2 in an Integrated Health System.Respiratory care · 2023Observational
- Acute clinical and financial outcomes of esophagectomy at safety-net hospitals in the United States.PloS one · 2023Article
- Understanding Sex-based Differences in Intensive Care Unit Mortality: Moving Beyond the Biology.American journal of respiratory and critical care medicine · 2022Article
- Postpartum readmissions for hypertensive disorders in pregnancy during the COVID-19 pandemic.AJOG global reports · 2022Article
- Defining value in cardiac surgery: A contemporary analysis of cost variation across the United States.JTCVS open · 2022Article
- Prevalence, characteristics, and longer-term outcomes of patients with persistent critical illness attributable to COVID-19 in Scotland: a national cohort study.British journal of anaesthesia · 2022Article
- Impact of frailty on persistent critical illness: a population-based cohort study.Intensive care medicine · 2022Article
- Variation in stroke care at the hospital level: A cross-sectional multicenter study.Frontiers in neurology · 2022Article
- Biological signatures and prediction of an immunosuppressive status-persistent critical illness-among orthopedic trauma patients using machine learning techniques.Frontiers in immunology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
purposePatients with persistent critical illness may account for up to half of all intensive care unit (ICU) bed-days. It is unknown if there is hospital variation in the development of persistent critical illness and if hospital performance affects the incidence of persistent critical illness.
methodsThis is a retrospective analysis of Veterans admitted to the Veterans Administration (VA) ICUs from 2015 to 2017. Hospital performance was defined by the risk- and reliability-adjusted 30-day mortality. Persistent critical illness was defined as an ICU length of stay of at least 11 days. We used 2-level multilevel logistic regression models to assess variation in risk- and reliability-adjusted probabilities in the development of persistent critical illness.
resultsIn the analysis of 100 hospitals which encompassed 153,512 hospitalizations, 4.9% (N = 7640/153,512) developed persistent critical illness. There was variation in the development of persistent critical illness despite controlling for patient characteristics (intraclass correlation: 0.067, 95% CI 0.049-0.091). Hospitals with higher risk- and reliability-adjusted 30-day mortality had higher probabilities of developing persistent critical illness (predicted probability: 0.057, 95% CI 0.051-0.063, p < 0.01) compared to those with lower risk- and reliability-adjusted 30-day mortality (predicted probability: 0.046, 95% CI 0.041-0.051, p < 0.01). The median odds ratio was 1.4 (95% CI 1.33-1.49) implying that, for two patients with the same physiology on admission at two different VA hospitals, the patient admitted to the hospital with higher adjusted mortality would have 40% greater odds of developing persistent critical illness.
conclusionHospitals with higher risk- and reliability-adjusted 30-day mortality have a higher probability of developing persistent critical illness. Understanding the drivers of this variation may identify modifiable factors contributing to the development of persistent critical illness.
Indexed as
Identifiers
What 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.