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Title of Journal: Intensive Care Med

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Abbravation: Intensive Care Medicine

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Springer-Verlag

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DOI

10.1016/j.bbrc.2007.12.171

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1432-1238

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More interventions do not necessarily improve outc

Authors: Philipp G H Metnitz Ana Reiter Barbara Jordan Thomas Lang
Publish Date: 2004/02/26
Volume: 30, Issue: 8, Pages: 1586-1593
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Abstract

The ICUs were divided into three groups according to the size and function of the hospital community hospitals and specialized trauma centers group A central referral hospitals group B and teaching hospitals group C Group C patients exhibited a significantly higher riskadjusted mortality O/E ratio Although severity of illness at admission in groups B and C was similar group C patients received significantly more invasive diagnostic and therapeutic interventions throughout their ICU stay For 7 of 10 invasive interventions identified odds ratios for group C vs group B patients were significantly increased even after adjustment for age gender severity of illness and reason for admission odds ratios 12–131 all 95 CIs 1 Riskadjusted multivariate analysis confirmed that six of these invasive interventions were independently associated with mortality Furthermore nursetopatient ratios did not differ between groups leading to a significantly increased nursing workload in group C ICUs

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