ICU sedation, delirium & recovery
Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis
Authors' conclusion
In a system with comparably high intensive care resources and mandatory staffing levels, patients' survival chances are generally not affected by high intensive care unit caseload and workload.
Study context
- Population
- Patients aged ≥ 18 years admitted to 144 Austrian intensive care units (ICUs), 2013–2022admissions to 144 ICUs
- Participants
- 415,584 patients
- Exposure
- ICU caseload and workload categories vs reference categories
- Outcome
- ICU mortality
Methodological detailsregistry-based, multicentre, time-dependent Cox proportional hazards model
- Registry-based
- Multicentre
- Time-dependent Cox proportional hazards model
Main finding
As reported in the abstract
ICU mortality by caseload and workload
Hazard ratio (95% CI)P value
Caseload > 100% vs Caseload 76 to 100%
1.06(0.99–1.15)
P = 0.110Caseload ≤ 50% vs Caseload 76 to 100%
1.09(1.02–1.16)
P = 0.008Caseload 51-75% vs Caseload 76 to 100%
1.10(1.05–1.15)
P < 0.0001TISS-28 ≤ 20 vs TISS-28 21-30
0.88(0.78–0.99)
P = 0.049Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| ICU mortality, caseload > 100%, intra-COVID period 2020–2022 (subgroup)> 100% vs 76 to 100% | 1.18 (1.06–1.30) | P = 0.001 | |
| ICU mortality by workload (median TISS-28)≤ 20 vs 21-30 | 0.88 (0.78–0.99) | P = 0.049 | |
| 0.512Hazard ratio (log scale) |
ICU mortality by workload, local hospitals (subgroup)
| HR (95% CI) | P value | ||
|---|---|---|---|
| 31-40vs reference median TISS-28 21-30 | 1.09 (1.01–1.19) | P = 0.035 | |
| > 40vs reference median TISS-28 21-30 | 1.28 (1.02–1.60) | P = 0.033 | |
| 0.512Hazard ratio (log scale) |
ICU mortality by workload (median TISS-28)
- Higher workloads not significantly associated with risk of death
Original publication
Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis. Crit Care. Published 14 September 2024. doi:10.
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