ArticleFrontiers in medicine2026
Impact of concordant ICU triage on hospital mortality: a nationwide retrospective multilevel analysis.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Specialty intensive care units (ICUs) provide diagnosis-specific patient care. Nonetheless, the advantage or disadvantage of ICU specialization remains debatable. We conducted a multicenter retrospective cohort study to evaluate the clinical outcomes of specialty ICUs in critical care. Methods: This retrospective study reviewed adult ICU patients in the eICU Collaborative Research Database (eICU-CRD), a United States (US)-based multicentered ICU cohort database. Patients over 16 years old with documented Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were enrolled and grouped by their admitted ICUs. Multilevel logistic regression models were performed to assess the relationships between hospital mortality and ICU type/ICU triage conditions in patients admitted with a diagnosis of cerebrovascular accident (CVA), acute coronary syndrome (ACS), coronary artery bypass graft (CABG), pneumonia (PNA) and other respiratory diseases, and trauma. A parallel multiple mediation analysis was performed to examine whether interventions in the ICU mediated the association between ICU triage and hospital mortality. Results: A total of 136,236 patients admitted to 271 ICUs from 186 hospitals were enrolled. In multilevel analysis, admission to cardiac ICU (OR: 0.81, Conclusion: Specialized concordant ICUs were not associated with lower hospital mortality risk compared to general ICUs after adjusting for confounders. Under resource-constrained settings, discordant ICU triage may be a viable option.
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