Association of ICU size and annual case volume of renal replacement therapy patients with mortality
Background We aimed to reveal whether the size of an intensive care unit (ICU) or its annual case volume of patients treated with renal replacement therapy (RRT) for acute kidney injury (AKI) is associated with hospital mortality. Methods This was a retrospective cohort study in the Finnish Intensiv...
Saved in:
Published in | Acta anaesthesiologica Scandinavica Vol. 56; no. 9; pp. 1175 - 1182 |
---|---|
Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford
Blackwell Publishing Ltd
01.10.2012
Blackwell Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Background
We aimed to reveal whether the size of an intensive care unit (ICU) or its annual case volume of patients treated with renal replacement therapy (RRT) for acute kidney injury (AKI) is associated with hospital mortality.
Methods
This was a retrospective cohort study in the Finnish Intensive Care Consortium (FICC) database in 2007–2008. We divided the 23 FICC‐member ICUs first into small or large according to ICU size, and second into low, medium, or high‐volume tertiles according to annual case volume of patients with RRT. We compared crude hospital mortality, Simplified Acute Physiology Score (SAPS) II‐, and case‐mix‐adjusted hospital mortality in small vs. large ICUs and in low‐ or medium‐volume vs. high‐volume ICUs.
Results
The median (interquartile range) annual case volume of patients with RRT for AKI per one ICU was 25 (19–45). Patients in small or low‐volume ICUs were older and less severely ill. Crude and SAPS II ‐adjusted hospital mortality rates were significantly higher in small ICUs but not significantly different in case volume tertiles. After adjusting for age, severity of illness, intensity of care, propensity to receive RRT, and day of RRT initiation, treatment in low or medium volume ICUs was associated with an increased risk for hospital mortality.
Conclusions
Crude and adjusted hospital mortality rates of patients treated with RRT for AKI were higher in small ICUs. Patients treated in high‐volume ICUs had a decreased adjusted risk for hospital mortality compared to those in low‐or medium volume ICUs. |
---|---|
Bibliography: | Academy of Finland Helsinki University Hospital - No. TYH 2010109; No. T102010070 istex:DFD2F15F50899CD462D7D28CDD85C7198DEDF38E Finnish Kidney Association ark:/67375/WNG-9LLF6HGZ-3 ArticleID:AAS2747 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0001-5172 1399-6576 |
DOI: | 10.1111/j.1399-6576.2012.02747.x |