The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
Comparison of Medical Admissions to Intensive Care Units in the United States and United Kingdom
Abstract
RATIONALE: The United States has seven times as many intensive care unit (ICU) beds per capita as the United Kingdom; the effect on care of critically ill patients is unknown. OBJECTIVES: To compare medical ICU admissions in the United States and United Kingdom. METHODS: Retrospective (2002-2004) cohort study of 172,785 ICU admissions (137 United States ICUs, Project IMPACT database; 160 United Kingdom ICUs, Case Mix Program) with patients followed until initial hospital discharge. MEASUREMENT AND MAIN RESULTS: United Kingdom (vs. United States) admissions were less likely to be admitted directly from the emergency room (ER) (33.4% vs. 58%); had longer hospital stays before ICU admission (mean days 2.6 ± 8.2 vs. 1 ± 3.6); and fewer were greater than or equal to 85 years (3.2% vs. 7.8%). United Kingdom patients were more frequently mechanically ventilated within 24 hours after ICU admission (68% vs. 27.4%); were sicker (mean Acute Physiology Score 16.7 ± 7.6 vs. 10.6 ± 6.8); and had higher primary hospital mortality (38% vs. 15.9%; adjusted odds ratio, 1.73; 95% confidence interval, 1.50-1.99). There was no mortality difference for mechanically ventilated patients admitted from the ER (adjusted odds ratio, 1.09; 95% confidence interval, 0.89-1.33). Comparisons of hospital mortality were confounded by differences in case mix; hospital length of stay (United Kingdom median 10 d [interquartile range {IQR}, 3-24] vs. United States 6 d [IQR, 3-11]; and discharge practices (more United States patients were discharged to skilled care facilities [29% of survivors vs. 6% in the United Kingdom]). CONCLUSIONS: Lower United Kingdom ICU bed availability is associated with fewer direct admissions from the ER, longer hospital stays before ICU admission, and higher severity of illness. Interpretation of between-country hospital outcomes is confounded by differences in case mix, processes of care, and discharge practices.
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Evolution of Mechanical Ventilation in Response to Clinical Research
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Variation in critical care services across North America and Western Europe*
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Self-citationHospital Volume and the Outcomes of Mechanical Ventilation
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Three-Year Outcomes for Medicare Beneficiaries Who Survive Intensive Care
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Self-citationLong-term Acute Care Hospital Utilization After Critical Illness
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The variability of critical care bed numbers in Europe
Rhodes, A., Ferdinande, P., Flaatten, H., Guidet, B., Metnitz, P. G., & Moreno, R. P. (2012) · Intensive Care Medicine · doi:10.1007/s00134-012-2627-8 · Cited by 667
Rhodes, A., Phillips, G., Beale, R., Cecconi, M., Chiche, J. D., De Backer, D., Divatia, J., Du, B., Evans, L., Ferrer, R., et al. (2015) · Intensive Care Medicine · doi:10.1007/s00134-015-3906-y · Cited by 398
ICU Occupancy and Mechanical Ventilator Use in the United States*
Wunsch, H., Wagner, J., Herlim, M., Chong, D. H., Kramer, A. A., & Halpern, S. D. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e318298a139 · Cited by 287
Self-citationIwashyna, T. J., Burke, J. F., Sussman, J. B., Prescott, H. C., Hayward, R. A., & Angus, D. C. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201411-2125cp · Cited by 276
Self-citationDevelopment and validation of early warning score system: A systematic literature review
Fu, L.-H., Schwartz, J., Moy, A., Knaplund, C., Kang, M.-J., Schnock, K. O., Garcia, J. P., Jia, H., Dykes, P. C., Cato, K., et al. (2020) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2020.103410 · Cited by 102
Metadata
- Authors
- Wunsch, H., Angus, D. C., Harrison, D. A., Linde-Zwirble, W. T., & Rowan, K. M.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-15
- Volume
- 183
- Issue
- 12
- Pages
- 1666-1673
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2117187812
- Cited by
- 256
- References
- 27
- FWCI
- 13.62
- Type
- journal article
- Language
- en
- Open access
- closed
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