Intensive care unit model and in-hospital mortality among patients with severe sepsis and septic shock: A secondary analysis of a multicenter prospective observational study

Isao Nagata, Toshikazu Abe, Hiroshi Ogura, Shigeki Kushimoto, Seitaro Fujishima, Satoshi Gando

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

We aimed to determine the association between the intensive care unit (ICU) model and in-hospital mortality of patients with severe sepsis and septic shock.This was a secondary analysis of a multicenter prospective observational study conducted in 59 ICUs in Japan from January 2016 to March 2017. We included adult patients (aged ≥16years) with severe sepsis and septic shock based on the sepsis-2 criteria who were admitted to an ICU with a 1:2 nurse-to-patient ratio per shift. Patients were categorized into open or closed ICU groups, according to the ICU model. The primary outcome was in-hospital mortality.A total of 1018 patients from 45 ICUs were included in this study. Patients in the closed ICU group had a higher severity score and higher organ failure incidence than those in the open ICU group. The compliance rate for the sepsis care 3-h bundle was higher in the closed ICU group than in the open ICU group. In-hospital mortality was not significantly different between the closed and open ICU groups in a multilevel logistic regression analysis (odds ratio =0.83, 95% confidence interval; 0.52-1.32, P=.43) and propensity score matching analysis (closed ICU, 21.2%; open ICU, 25.7%, P=.22).In-hospital mortality between the closed and open ICU groups was not significantly different after adjusting for ICU structure and compliance with the sepsis care bundle.

Original languageEnglish
Pages (from-to)E26132
JournalMedicine (United States)
Volume100
Issue number21
DOIs
Publication statusPublished - 2021 May 28

Keywords

  • ICU model
  • in-hospital mortality
  • sepsis
  • sepsis care bundle

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