Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: a report from the National Registry for Cardiopulmonary Resuscitation.

Aim: To evaluate key pre-arrest factors and their collective ability to predict post-cardiopulmonary arrest mortality. CPR is often initiated indiscriminately after in-hospital cardiopulmonary arrest. Improved understanding of pre-arrest factors associated with mortality may inform advance care planning.

Subgroup mortality probability models: are they necessary for specialized intensive care units?

Objectives: To examine the sensitivity of the performance of the latest Mortality Probability Model at intensive care unit admission (MPM0-III) to case-mix variations and to determine how specialized models for these subgroups would affect intensive care unit performance assessment. MPM0-III is an important benchmarking tool for intensive care units in Project IMPACT. Overall, MPM0-III has excellent discrimination and calibration but its performance varies on six common patient subsets.

A revised method to assess intensive care unit clinical performance and resource utilization.

Objective: In 1994, Rapoport et al. published a two-dimensional graphical tool for benchmarking intensive care units (ICUs) using a Mortality Probability Model (MPM0-II) to assess clinical performance and a Weighted Hospital Days scale (WHD-94) to assess resource utilization. MPM0-II and WHD-94 do not calibrate on contemporary data, giving users of the graph an inflated assessment of their ICU's performance.

Assessing contemporary intensive care unit outcome: an updated Mortality Probability Admission Model (MPM0-III).

Objective: To update the Mortality Probability Model at intensive care unit (ICU) admission (MPM0-II) using contemporary data.

Design: Retrospective analysis of data from 124,855 patients admitted to 135 ICUs at 98 hospitals participating in Project IMPACT between 2001 and 2004. Independent variables considered were 15 MPM0-II variables, time before ICU admission, and code status.

Variability in trauma center outcomes for patients with moderate intracranial injury.

Background: The variability of outcome between Trauma Centers has not been extensively studied as a possible avenue for performance improvement. Trauma Center variability in severity-adjusted survival for patients with moderate intracranial injury (MII) was studied in order to determine the association of MII-related process of care variables with outcomes. The analytic results were supplemented with peer review of MII patients with unexpected outcomes and identified potential process of care variables.