Evidence map›Paper›PMID 32748188›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

How the high acuity unit changes mortality in the intensive care unit: a retrospective before-and-after study.

Anish R Mitra, Donald E G Griesdale, Gregory Haljan, Ashley O'Donoghue, Jennifer P Stevens

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Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anish R MitraDivision of Critical Care Medicine, Department of Medicine, Surrey Memorial Hospital, Surrey, BC, Canada. anish.mitra@fraserhealth.ca.ORCID http://orcid.org/0000-0001-8151-3972
Donald E G GriesdaleDepartment of Medicine and Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada.
Gregory HaljanDivision of Critical Care Medicine, Department of Medicine, Surrey Memorial Hospital, Surrey, BC, Canada.
Ashley O'DonoghueCenter for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jennifer P StevensCenter for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHigh acuity units (HAU) are hospital units that provide patients with more acute care and closer monitoring than a general hospital ward but are not as resource intensive as an intensive care unit (ICU). Nevertheless, the impact of opening a HAU on ICU patient outcomes remains poorly defined. We investigated how the creation of a HAU impacted patient outcomes in the ICU.

methodsThis historical cohort study compared ICU patient in-hospital mortality, ICU length of stay (LOS), and hospital LOS before and after the creation of a HAU in a tertiary-care hospital with a medical/surgical ICU between 1 January 2013 and 31 December 2017.

resultsData from 4,380 patients (984 in the pre-HAU group and 3,396 in the post-HAU group) were analyzed. In this cohort of ICU patients, 360 (37%) died in the pre-HAU group before the creation of a HAU, and 1,074 (32%) died in the post-HAU group after the creation of a HAU. The creation of a HAU was associated with lower relative risk of in-hospital mortality (adjusted risk ratio, 0.80; 95% confidence interval [CI], 0.72 to 0.89; P < 0.001). The creation of a HAU was also associated with reduced ICU and hospital LOS with a 12% increase in the rate of ICU discharge (adjusted sub-distribution hazard ratio [SHR], 1.12; 95% CI, 1.02 to 1.23; P = 0.02) and a 26% increase in the rate of hospital discharge (adjusted SHR, 1.26; 95% CI, 1.14 to 1.39; P < 0.001), when accounting for the competing risk of death.

conclusionsThese data support the hypothesis that the creation of a HAU may be associated with reduced in-hospital mortality, ICU LOS, and hospital LOS for ICU patients.

Indexed as

Intensive Care UnitsCohort StudiesHospital MortalityHumansLength of StayRetrospective Studies

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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.