Trends in ICU mortality and underlying risk over three decades among mechanically ventilated patients. A group level analysis of cohorts from infection prevention studies
Authors' conclusion
Mortality incidence has changed little over 35 years among ICU infection prevention studies whilst the patient age and underlying disease severity, measured as APACHE II, have both increased.
Study context
- Population
- ICU patients receiving mechanical ventilation (MV) (>50% >24 h) in VAP prevention studies, 1985–2021210 studies
- Comparison
- Mortality incidence vs publication year, adjusted for age, APACHE II, intervention type
- Primary endpoint
- Change per decade in ICU mortality incidence
Primary result
As reported in the abstract
Change per decade
Increase in mean mortality incidence per decade
< 1 percentage point
p = 0.43
Increase in group-mean APACHE II score per decade
1.83 (95% CI; 0.51-3.15) points
Increase in group-mean age per decade
3.9 (95% CI; 1.1-6.7) years
Further findings
Risk-adjusted mortality trend
- Significant decline in mortality only with adjustment for both group-mean age and APACHE II
Mortality in concurrent control groups of decontamination studies
- Higher than benchmark, with greater dispersion, in all models
- five percentage points
Original publication
Trends in ICU mortality and underlying risk over three decades among mechanically ventilated patients. A group level analysis of cohorts from infection prevention studies. Ann Intensive Care. Published 11 July 2023. doi:10.
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