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Chest. 2011 Nov;140(5):1232-1242. doi: 10.1378/chest.11-0718. Epub 2011 Aug 25.

Benchmark data from more than 240,000 adults that reflect the current practice of critical care in the United States.

Author information

1
Department of Medicine, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; Department of Anesthesiology, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; Department of Surgery, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; School of Medicine, and the Clinical and Population Health Research Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA. Electronic address: craig.lilly@umassmed.edu.
2
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
3
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD; Philips Healthcare, Baltimore, MD.
4
Department of Critical Care Medicine, Maine Medical Center, Portland, ME; Tufts Medical School, Boston, MA.

Abstract

BACKGROUND:

Nationwide benchmarks representing current critical care practice for the range of ICUs are lacking. This information may highlight opportunities for care improvement and allows comparison of ICU practice data.

METHODS:

Data representing 243,553 adult admissions from 271 ICUs and 188 US nonfederal hospitals during 2008 were analyzed using the eICU Research Institute clinical practice database. Participating ICUs and hospitals varied widely regarding bed number, community size, academic status, geographic location, and organizational structure.

RESULTS:

More than one-half of these critically ill adults were < 65 years old, and most patients returned to their homes after hospital discharge. Most patients were admitted from an ED, had a medical admission diagnosis, and received antimicrobial therapy. Intensive treatment was common, including 27% who received mechanical ventilation, 7.5% who were supported with noninvasive ventilation, 24.3% who were treated with vasoactive infusions, > 20% who received a blood product, and 4.4% who agreed to a care limitation order during their ICU stay. Forty percent of cases had a < 10% mortality risk and did not have an intensive treatment documented.

CONCLUSIONS:

Admission to an ICU in 2008 involved active treatments that often included life support and counseling for those near the end of life and was associated with favorable outcomes for most patients.

PMID:
21868469
DOI:
10.1378/chest.11-0718
[Indexed for MEDLINE]
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