The influence of volume and intensive care unit organization on hospital mortality in patients admitted with severe sepsis: a retrospective multicentre cohort study

• DOI: 10.1186/cc5727
• Publication Date: 2007-04-30T15:51:05Z
• Authors: Linda Peelen; Nicolette F de Ke...; Niels Peek; Gert Jan Scheffer; Peter HJ van der ...; Evert de Jonge
• Keywords: Male; DCN 1: Perception and Action; UMCN 4.2: Chronic inflammation and autoimmunity; Research; N4i 1: Pathogenesis and modulation of inflammation; Middle Aged; Critical Care and Intensive Care Medicine; 3. Good health; Cohort Studies; Intensive Care Units; N4i 4: Auto-immunity, transplantation and immunotherapy; Sepsis; Humans; Female; Hospital Mortality; Netherlands; Retrospective Studies

Abstract Introduction The aim of the study was to assess influence annual volume and factors related intensive care unit (ICU) organization on in-hospital mortality among patients admitted ICU with severe sepsis. Methods A retrospective cohort conducted using database Dutch National Intensive Care Evaluation (NICE) registry. Analyses were based consecutive between 1 January 2003 30 June 2005 who fulfilled criteria for sepsis within first 24 hours admission. 13-item questionnaire sent all 32 ICUs across Netherlands that participated in NICE registry this period order obtain information staffing. association investigated logistic regression analysis, combined generalized estimation equations account potential correlations outcomes ICUs. Correction patient-related took place by including Simplified Acute Physiology Score II, age, sex number dysfunctioning organ systems analyses. Results 4,605 from 28 (questionnaire response rate 90.6%) revealed a higher is associated lower ( P = 0.029). presence medium (MCU) as step-down facility intermediate 0.013). For other items regarding organization, no independent significant relationships found. Conclusion larger patient group. MCU greater mortality. No associations