Other bulletins in this series include:

Breast Surgery

Wednesday 16 December 2009

Association between ICU admission during morning rounds and mortality

Association between ICU admission during morning rounds and mortality. CHEST, Dec. 2009 vol. 136(6), p. 1489-1495.

Afessa, B. et al.

http://chestjournal.chestpubs.org/content/136/6/1489.full

Background: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. Conclusions: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates.

Evaluation of modernisation of adult critical care services in England

Evaluation of modernisation of adult critical care services in England: time series and cost effectiveness analysis. BMJ 2009;339:b4353

Hutchings, A., et al.

http://sccmwww.sccm.org/publications/eNewsletters_Archive/11_19_2009.htm#n1
(Click on link: British Medical Journal, full text)

Objective: To evaluate the impact and cost effectiveness of a programme to transform adult critical care throughout England initiated in late 2000. Design: Evaluation of trends in inputs, processes, and outcomes during 1998-2000 compared with last quarter of 2000-6.
Setting: 96 critical care units in England. Participants: 349 817 admissions to critical care units. Conclusion: Substantial improvements in NHS critical care have occurred in England since 2000. While it is unclear which factors were responsible, collectively the interventions represented a highly cost effective use of NHS resources.

Potential for response bias in family surveys about end-of-life care in the ICU

Potential for response bias in family surveys about end-of-life care in the ICU. CHEST, Dec. 2009, vol. 136 (6), p. 1496-1502.

Kross, E.K., et al.

http://chestjournal.chestpubs.org/content/136/6/1496.full

After-death surveys are an important source of information about the quality of end-of-life care, but response rates generally are low. Our goal was to understand the potential for nonresponse bias in survey studies of family members after a patient's death in the hospital ICU by identifying differences in patient demographics and delivery of palliative care between patients whose families respond to a survey about end-of-life care and those whose families do not.

International study of the prevalence and outcomes of infection in ICUs

International study of the prevalence and outcomes of infection in ICUs. JAMA. 2009;302(21):2323-2329.

Vincent, J.L. et al.

http://jama.ama-assn.org/cgi/content/full/302/21/2323

Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. However, relatively little information is available about the global epidemiology of such infections. Objective: To provide an up-to-date, international picture of the extent and patterns of infection in ICUs. Conclusions: Infections are common in patients in contemporary ICUs, and risk of infection increases with duration of ICU stay. In this large cohort, infection was independently associated with an increased risk of hospital death.