Transition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes.


Journal

Journal of the American Heart Association
ISSN: 2047-9980
Titre abrégé: J Am Heart Assoc
Pays: England
ID NLM: 101580524

Informations de publication

Date de publication:
02 02 2021
Historique:
pubmed: 9 1 2021
medline: 14 10 2021
entrez: 8 1 2021
Statut: ppublish

Résumé

Background Several studies have shown improved outcomes in closed compared with open medical and surgical intensive care units. However, very little is known about the ideal organizational structure in the modern cardiac intensive care unit (CICU). Methods and Results We retrospectively reviewed consecutive unique admissions (n=3996) to our tertiary care CICU from September 2013 to October 2017. The aim of our study was to assess for differences in clinical outcomes between an open compared with a closed CICU. We used multivariable logistic regression adjusting for demographics, comorbidities, and severity of illness. The primary outcome was in-hospital mortality. We identified 2226 patients in the open unit and 1770 in the closed CICU. The unadjusted in-hospital mortality in the open compared with closed unit was 9.6% and 8.9%, respectively (

Identifiants

pubmed: 33412899
doi: 10.1161/JAHA.120.018182
pmc: PMC7955420
doi:

Types de publication

Comparative Study Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e018182

Subventions

Organisme : NCATS NIH HHS
ID : TL1 TR001864
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States

Références

IEEE J Biomed Health Inform. 2017 Nov;21(6):1719-1729
pubmed: 28287993
J Am Coll Cardiol. 2018 Sep 25;72(13):1532-1553
pubmed: 30236315
J Am Coll Cardiol. 2018 Oct 30;72(18):2269-2271
pubmed: 30360831
Am J Respir Crit Care Med. 1998 May;157(5 Pt 1):1468-73
pubmed: 9603125
Crit Care Med. 2006 Feb;34(2):387-95
pubmed: 16424719
JAMA Cardiol. 2019 Sep 1;4(9):928-935
pubmed: 31339509
J Trauma Acute Care Surg. 2019 Apr;86(4):635-641
pubmed: 30629013
Circ Res. 2015 Jun 5;116(12):2041-9
pubmed: 26044255
Crit Pathw Cardiol. 2017 Jun;16(2):62-70
pubmed: 28509706
J Am Coll Cardiol. 2017 Apr 25;69(16):1999-2007
pubmed: 28427574
Crit Care Med. 2004 Nov;32(11):2311-7
pubmed: 15640647
J Am Coll Cardiol. 2016 Jul 5;68(1):67-79
pubmed: 27364053
Am J Infect Control. 2016 Dec 1;44(12):1744-1746
pubmed: 27397908
BMC Surg. 2011 Aug 23;11:18
pubmed: 21861878
J Am Coll Cardiol. 2016 Dec 20;68(24):2637-2648
pubmed: 27978948
Am Surg. 2011 Oct;77(10):1334-6
pubmed: 22127082
Am J Respir Crit Care Med. 2007 Oct 1;176(7):685-90
pubmed: 17556721
Eur Heart J. 2019 Aug 21;40(32):2671-2683
pubmed: 31274157
JAMA. 1996 Jul 24-31;276(4):322-8
pubmed: 8656546
Circ Cardiovasc Qual Outcomes. 2017 Aug;10(8):e003616
pubmed: 28794121
J Am Heart Assoc. 2021 Feb 2;10(3):e018182
pubmed: 33412899
Circ Cardiovasc Qual Outcomes. 2017 Aug;10(8):e003864
pubmed: 28794122
Crit Care Med. 2012 Oct;40(10):2754-9
pubmed: 22824939
J Biomed Inform. 2013 Oct;46(5):837-48
pubmed: 23831554
Lancet. 1961 Oct 14;2(7207):840-4
pubmed: 14452757
J Am Coll Cardiol. 2019 Apr 9;73(13):1726-1730
pubmed: 30947926
Ann Surg. 1999 Feb;229(2):163-71
pubmed: 10024095
J Am Coll Cardiol. 2016 Dec 20;68(24):2649-2651
pubmed: 27978949
N Engl J Med. 2017 Sep 14;377(11):1055-1064
pubmed: 28902587
Circulation. 2012 Sep 11;126(11):1408-28
pubmed: 22893607

Auteurs

P Elliott Miller (PE)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.
Yale National Clinicians Scholar Program New Haven CT.

Fouad Chouairi (F)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.

Alexander Thomas (A)

Department of Internal Medicine Yale School of Medicine New Haven CT.

Yukiko Kunitomo (Y)

Department of Internal Medicine Yale School of Medicine New Haven CT.

Faisal Aslam (F)

Department of Internal Medicine Yale School of Medicine New Haven CT.

Maureen E Canavan (ME)

Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center Yale School of Medicine New Haven CT.

Christa Murphy (C)

Yale New Haven Hospital New Haven CT.

Krishna Daggula (K)

Joint Data Analytics Team Yale New Haven Hospital New Haven CT.

Thomas Metkus (T)

Division of Cardiology Department of Medicine Johns Hopkins University School of Medicine Baltimore MD.

Saraschandra Vallabhajosyula (S)

Department of Cardiovascular Medicine Mayo Clinic Rochester MN.

Anthony Carnicelli (A)

Section of Cardiovascular Medicine Duke University Durham NC.

Jason N Katz (JN)

Section of Cardiovascular Medicine Duke University Durham NC.

Nihar R Desai (NR)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.
Center for Outcomes Research & Evaluation (CORE) Yale School of Medicine New Haven CT.

Tariq Ahmad (T)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.
Center for Outcomes Research & Evaluation (CORE) Yale School of Medicine New Haven CT.

Eric J Velazquez (EJ)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.

Joseph Brennan (J)

Section of Cardiovascular Medicine Yale School of Medicine New Haven CT.

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Classifications MeSH