Intensive Care Medicine

, Volume 36, Issue 4, pp 673–679

Are small hospitals with small intensive care units able to treat patients with severe sepsis?

  • Matti Reinikainen
  • Sari Karlsson
  • Tero Varpula
  • Ilkka Parviainen
  • Esko Ruokonen
  • Marjut Varpula
  • Tero Ala-Kokko
  • Ville Pettilä
Original

DOI: 10.1007/s00134-009-1688-9

Cite this article as:
Reinikainen, M., Karlsson, S., Varpula, T. et al. Intensive Care Med (2010) 36: 673. doi:10.1007/s00134-009-1688-9

Abstract

Purpose

To find out whether mortality from sepsis is influenced by the size of the hospital and of the intensive care unit (ICU).

Methods

In the Finnsepsis study, 470 patients with severe sepsis were identified. The present study is a retrospective subgroup analysis of the Finnsepsis study. Eighteen patients were excluded because of treatment in more than one ICU. We divided the 24 units into three groups based on hospital size and academic status.

Results

There were no significant differences between the ICU groups in terms of severity of illness. Overall, the hospital mortality rate was 29.2%. In post-operative patients, the hospital mortality rate was 22.9% for patients treated in large ICUs (including university and large non-university hospital ICUs) but 42.3% for patients treated in small ICUs (p = 0.045). In medical patients, no differences in outcomes were found.

Conclusions

Treatment of surgical patients with severe sepsis in small ICUs was associated with increased mortality. Because of the relatively small sample size, further studies are needed to confirm or refute this association.

Keywords

Intensive careICUSizeSepsisOutcomeMortality

Copyright information

© Copyright jointly hold by Springer and ESICM 2010

Authors and Affiliations

  • Matti Reinikainen
    • 1
  • Sari Karlsson
    • 2
  • Tero Varpula
    • 3
  • Ilkka Parviainen
    • 4
  • Esko Ruokonen
    • 4
  • Marjut Varpula
    • 3
  • Tero Ala-Kokko
    • 5
  • Ville Pettilä
    • 3
  1. 1.Department of Intensive CareNorth Karelia Central HospitalJoensuuFinland
  2. 2.Department of Intensive CareTampere University HospitalTampereFinland
  3. 3.Intensive Care Units, Division of Anaesthesiology and Intensive Care Medicine, Department of SurgeryHelsinki University Central HospitalHelsinkiFinland
  4. 4.Department of Intensive CareKuopio University HospitalKuopioFinland
  5. 5.Division of Intensive Care, Department of AnaesthesiologyOulu University HospitalOuluFinland