Respiratory failure & ventilation
Impact of board-certified intensive care training facilities on choice of adjunctive therapies and prognosis of severe respiratory failure: a nationwide cohort study
Main finding · In-hospital mortalityResult — go to the resultOdds ratio 0.75 95% CI 0.72–0.77Authors' conclusion
Board-certified intensive care training facilities implemented several different adjunctive treatments for severe respiratory failure compared to non-board-certified facilities, and board-certified facilities were associated with lower in-hospital mortality.
Study context
- Population
- Patients with non-operative severe respiratory failure requiring mechanical ventilation for over 4 days, Japan, 2016–2019
- Participants
- 66,905 patients
- Exposure
- Board-certified vs Non-certified
- Board-certifiedn = 30,588
- Non-certifiedn = 36,317reference
- Outcome
- In-hospital mortality
Methodological detailsnationwide in-patient database, propensity score matched (1:1)
- Nationwide in-patient database
- Propensity score matched (1:1)
Main finding
As reported in the abstract
Odds ratio
0.75
95% CI 0.72–0.77
P < 0.001
By group
Board-certified vs Non-certified
OR 0.75 (95% CI 0.72–0.77); P < 0.001
Observational data: associations, not effects.
Further findings
Treatments used (unmatched)
- Propofol, board-certified vs non-certified
- 35% vs. 18%
- Dexmedetomidine
- 37% vs. 19%
- Fentanyl
- 50% vs. 20%
- Rocuronium
- 8.5% vs. 2.6%
- Vecuronium
- 1.9% vs. 0.6%
- Noradrenaline
- 35% vs. 19%
- Arginine vasopressin
- 8.1% vs. 2.0%
- Adrenaline
- 2.3% vs. 1.0%
- Dobutamine
- 8.7% vs. 4.8%
- Phosphodiesterase inhibitors
- 1.0% vs. 0.3%
- Early enteral nutrition
- 29% vs. 14%
- Early rehabilitation
- 34% vs. 30%
- RRT
- 15% vs. 6.7%
- ECMO
- 1.6% vs. 0.3%
- Critical care unit admission
- 74% vs. 30%
- Dopamine
- 9.0% vs. 15%
- Sivelestat
- 4.1% vs. 7.0%
- High-dose methylprednisolone
- 13% vs. 15%
In-hospital mortality (subgroups)
- Greater benefit of board-certified facilities in older patients, those requiring vasopressors on the first day of mechanical ventilation, and those treated in critical care units
Original publication
Impact of board-certified intensive care training facilities on choice of adjunctive therapies and prognosis of severe respiratory failure: a nationwide cohort study. J Intensive Care. Published 19 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →