Related Experiment Video
Updated: Sep 12, 2025
Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
The Association of ICU Acuity and Organizational Factors With Outcomes of Low-Risk Patients
Emmanuel S Salgueiro1,2, Pedro Kurtz3,4,5, Lunna P Borges6
1Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, (UFRJ), Rio de Janeiro, Brazil.
Objective:
Outcomes of low-risk patients may be affected by the overall acuity of the ICU to which they were admitted. Studies addressing this topic are very scarce and the underlying mechanisms supporting this association remain incompletely understood. Here, we investigated the effects of ICU acuity (defined as the mean Simplified Acute Physiology Score 3 of all admitted patients in the bimester in which a given patient was admitted) and organizational factors on the outcomes of patients with a low risk of dying admitted to ICUs.
Design:
Retrospective cohort study.
Setting:
One hundred and thirty-four ICUs from Brazil and Uruguay.
Patients:
All low-risk (defined as a Simplified Acute Physiology Score 3 probability of death < 3%) patients admitted between 2016 and 2018.
Interventions:
None.
Measurements And Main Results:
The primary outcome was hospital mortality; secondary outcomes were ICU mortality, and ICU and hospital lengths of stay (LOS). ICU acuity was evaluated as a continuous variable. Multilevel multivariable regression analyses were used to explore the association between ICU acuity, organizational characteristics, and outcomes. Of 285,553 patients, 69,675 (24.4%) were considered low risk. Elective surgeries (66.2%) were the main admission reason. In the models adjusted for patient- and ICU-level characteristics, ICU acuity was not associated with hospital mortality (odds ratio [OR] = 1.095 [0.942-1.274]) and all secondary outcomes. These results were consistent in sensitivity analyses. The presence of dedicated pharmacists in the ICU (OR = 0.531 [0.365-0.773]) and the number of implemented clinical protocols (OR = 0.817 [0.688-0.970]) were independently associated with lower hospital mortality. Clinical protocols were also associated with shorter ICU and hospital LOS.
Conclusions:
ICU acuity was not associated with outcomes in low-risk patients. Appropriate multidisciplinary staffing coupled with adherence to best clinical practices are essential to optimize efficiency and minimize variability of care for this population.
More Related Videos
10:38Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include: