, Volume 22, Issue 7, pp 664-669

The importance of technology for achieving superior outcomes from intensive care

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Abstract

Objective

To test the hypothesis that technology availability, staffing, and diagnostic diversity in an intensive care unit (ICU) are associated with the ability to decrease hospital mortality.

Design

Prospective multicenter descriptive cohort study.

Setting

Ten Brazilian medical-surgical ICUs.

Patients

1734 consecutive adult ICU admissions.

Measurements and results

We recorded t the amount of technology, number of diagnoses, and availability of nurses at each ICU. We also used demographic, clinical and physiologic information for an average of 173 admissions to each ICU to calculate standardized mortality ratios (SMRs) for each ICU. The mean SMR for the ten ICUs was 1.67 (range 1.01–2.30). A greater availability of ICU equipment and services was significantly (p<0.001) associated with a lower SMR.

Conclusion

The ability of Brazilian ICUs to reduce hospital mortality is associated with the amount of technology available in these units.

Supported by the Agency for Health Care Policy and Research (HSO7173); tHE jOHN A. Hartford Foundation (87267); The Department of Anesthesiology, The George Washington University medical Center; The National Council of Scientific and Technology Development (CNPq), Brazil (No. 202321/98.4); and APACHE Medical Systems Inc
A complete list of study hospitals and participants appears at the end of this article.