Purpose: The impact of intensivist workload on intensive care unit (ICU) outcomes is incompletely described and assessed across healthcare systems and countries. We sought to examine the association of patient-to-intensivist ratio (PIR) with hospital mortality in Australia/New Zealand (ANZ) ICUs.
Methods: We conducted a retrospective study of adult admissions to ANZ ICUs (August 2016-June 2018) using two cohorts: "narrow", based on previously used criteria including restriction to ICUs with a single daytime intensivist; and "broad", refined by individual ICU daytime staffing information. The exposure was average daily PIR and the outcome was hospital mortality. We used summary statistics to describe both cohorts and multilevel multivariable logistic regression models to assess the association of PIR with mortality. In each, PIR was modeled using restricted cubic splines to allow for non-linear associations. The broad cohort model included non-PIR physician and non-physician staffing covariables.
Results: The narrow cohort of 27,380 patients across 67 ICUs (predicted mortality: median 1.2% [IQR 0.4-1.4%]; mean 5.9% [sd 13.2%]) had a median PIR of 10.1 (IQR 7-14). The broad cohort of 91,206 patients across 73 ICUs (predicted mortality: 1.9% [0.6-6.5%]; 7.6% [14.9%]) had a median PIR of 7.8 (IQR 5.8-10.2). We found no association of PIR with mortality in either the narrow (PIR 1st spline term odds ratio [95% CI]: 1 [0.94, 1.06], Wald testing of spline terms p = 0.61) or the broad (1.02 [0.97, 1.07], p = 0.4) cohort.
Conclusion: We found no association of PIR with hospital mortality across ANZ ICUs. The low cohort predicted mortality may limit external validity.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638228 | PMC |
| http://dx.doi.org/10.1007/s00134-021-06575-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Artificial Intelligence in Pancreatic Imaging: A Systematic Review.
United European Gastroenterol J
January 2025
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
The rising incidence of pancreatic diseases, including acute and chronic pancreatitis and various pancreatic neoplasms, poses a significant global health challenge. Pancreatic ductal adenocarcinoma (PDAC) for example, has a high mortality rate due to late-stage diagnosis and its inaccessible location. Advances in imaging technologies, though improving diagnostic capabilities, still necessitate biopsy confirmation.
View Article and Find Full Text PDFRIOK1: A Novel Oncogenic Driver in Hepatocellular Carcinoma.
Cancer Med
February 2025
Centre for Medical Research, Ningbo No.2 Hospital, Ningbo, China.
Background: Hepatocellular carcinoma (HCC) is one of the most common and highly lethal cancers worldwide. RIO kinase 1 (RIOK1), a protein kinase/ATPase that plays a key role in regulating translation and ribosome assembly, is associated with a variety of malignant tumors. However, the role of RIOK1 in HCC remains largely unknown.
View Article and Find Full Text PDFCharacterization of Hospital Admissions During Immune Checkpoint Inhibitor Therapy: Insights From the ICOG Study.
Cancer Med
February 2025
Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
Introduction: Immune checkpoint inhibitors (ICI) have improved the therapeutic arsenal in outpatient oncology care; however, data on necessity of hospitalizations associated with immune-related adverse events (irAEs) are scarce. Here, we characterized hospitalizations of patients undergoing ICI, from the prospective cohort study of the immune cooperative oncology group (ICOG) Hannover.
Methods: Between 12/2019 and 06/2022, 237 patients were included.
Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.
Transfus Med
January 2025
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Objectives: Trauma-induced coagulopathy (TIC) can be fatal but preventable if recognised early. With emerging uses of rotational thromboelastometry (ROTEM) to guide transfusions in trauma, patient outcomes with TIC-defined by initial ROTEM and conventional coagulation tests (CCTs) during massive haemorrhage protocol (MHP) activations were evaluated at a primary trauma centre in British Columbia.
Methods: This retrospective observational study included adult trauma patients requiring MHP from June 1, 2020, to May 31, 2022.
The role of myocardial energy metabolism perturbations in diabetic cardiomyopathy: from the perspective of novel protein post-translational modifications.
Clin Epigenetics
January 2025
Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
Diabetic cardiomyopathy (DbCM), a significant chronic complication of diabetes, manifests as myocardial hypertrophy, fibrosis, and other pathological alterations that substantially impact cardiac function and elevate the risk of cardiovascular diseases and patient mortality. Myocardial energy metabolism disturbances in DbCM, encompassing glucose, fatty acid, ketone body and lactate metabolism, are crucial factors that contribute to the progression of DbCM. In recent years, novel protein post-translational modifications (PTMs) such as lactylation, β-hydroxybutyrylation, and succinylation have been demonstrated to be intimately associated with the myocardial energy metabolism process, and in conjunction with acetylation, they participate in the regulation of protein activity and gene expression activity in cardiomyocytes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!