Two Decades of ICU Utilization and Hospital Outcomes in a XXXX Center.

@entity1 @entity295 @entity55 @entity5 @entity1503 @entity601
OBJECTIVE: To investigate ICU utilization and hospital outcomes of oncological @entity1 admitted to a comprehensive @entity5 center. DESIGN: Observational cohort study. SETTING: The University of Texas @entity601 Anderson @entity5 Center. @entity1 : Consecutive adults with @entity5 discharged over a 20-year period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The Cochran-Armitage test for trend was used to evaluate ICU utilization and hospital mortality rates by primary service over time. A negative binomial log linear regression model was fitted to the data to investigate length of stay over time. Among 387,306 adult hospitalized @entity1 , the ICU utilization rate was 12.9%. The overall hospital mortality rate was 3.6%: 16.2% among @entity1 with an ICU stay and 1.8% among non-ICU @entity1 . Among those admitted to the ICU, the mean (SD) admission Sequential Organ Failure Assessment score was 6.1 (3.8) for all ICU @entity1 : 7.3 (4.4) for medical ICU @entity1 and 4.9 (2.8) for surgical ICU @entity1 . @entity1503 were associated with the highest hospital mortality rate in ICU @entity1 (42.8%); metastatic disease had the highest mortality rate in non-ICU @entity1 (4.2%); @entity295 , @entity55 , and other infections had the highest mortality rate for all inpatients (8.5%). CONCLUSIONS: This study provides a longitudinal view of ICU utilization rates, hospital and ICU length of stay, and severity-adjusted mortality rates. Although the data arise from a single institution, it encompasses a large number of hospital admissions over two decades and can serve as a point of comparison for future oncological studies at similar institutions. More studies of this nature are needed to determine whether consolidation of @entity5 care into specialized large-volume facilities may improve outcomes, while simultaneously sustaining appropriate resource utilization and reducing unnecessary healthcare costs.
