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Intensive Care Medicine
Published in: Intensive Care Medicine 2/2015

01-02-2015 | Editorial

Comparing intensive care units by size or level

Authors: Dylan W. de Lange, Hannah Wunsch, Jozef Kesecioglu

Published in: Intensive Care Medicine | Issue 2/2015

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Excerpt

Practice makes perfect! The association between higher volumes and better outcomes is nowadays a generally accepted motivation for concentration of care. The strongest associations are found when the task or treatment is high risk or of high complexity. In trauma surgery, percutaneous coronary interventions in myocardial infarction, and many high-risk surgical procedures such a correlation between volume and outcome has been established [1]. It is very tempting to assume that such a volume–outcome relationship does exist for intensive care units (ICUs) as well, which combine both high risk and high complexity. Indeed, several studies have shown a better hospital outcome for high-volume ICUs in comparison to low-volume ICUs [2]. The question really is “is it merely volume or are other variables influencing outcome as well?” …
Literature
1.
Fernández R, Altaba S, Cabre L, Lacueva V, Santos A, Solsona JF et al (2013) Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients. Anesthesiology 119(4):871–879PubMedCrossRef
2.
Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O’Brien CR, Rubenfeld GD (2006) Hospital volume and the outcomes of mechanical ventilation. N Engl J Med 355(1):41–45PubMedCrossRef
3.
Kluge GH, Brinkman S, van Berkel G, van der Hoeven J, Jacobs C, Snel YEM, Vogelaar JPM, de Keizer NF, Boon ES (2015) The association between ICU level of care and mortality in the Netherlands. Intensive Care Med. doi:10.​1007/​s00134-014-3620-1 PubMed
4.
Brinkman S, Abu-Hanna A, van der Veen A, de Jonge E, de Keizer NF (2012) A comparison of the performance of a model based on administrative data and a model based on clinical data: effect of severity of illness on standardized mortality ratios of intensive care units. Crit Care Med 40(2):373–378PubMedCrossRef
Metadata
Title
Comparing intensive care units by size or level
Authors
Dylan W. de Lange
Hannah Wunsch
Jozef Kesecioglu
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-3678-4

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