The Case Mix Programme (CMP) is a national comparative audit of adult, general ICUs
\n (including intensive care units and combined intensive care and high dependency units,
\n but not coronary care units) in England, Wales and Northern Ireland co-ordinated by
\n ICNARC. The CMP has received approval from the Patient Information Advisory Group
\n to hold patient identifiable information without consent (approval number PIAG 2-10(f)\/2005).
\n Approval by a research ethics committee was not required. Details of the data collection
\n and validation have been reported previously 12<\/a>].\n <\/p>\n
We undertook a prospectively defined, retrospective analysis of the ICNARC CMPD for
\n the period 1 January 2004 to 31 December 2014. Admissions, mechanically ventilated
\n in the first 24\u00a0hours in the critical care unit and admitted following CPR, defined
\n as the delivery of chest compressions in the 24\u00a0hours before admission, were identified.
\n Patients sustaining a cardiac arrest in ICU (but not before admission) were excluded
\n from the analysis.\n <\/p>\n
The admissions that were identified were then grouped in the following way:<\/p>\n
Out-of-hospital cardiac arrest:<\/strong> location immediately prior to source of admission to the unit as \u2018clinic or home\u2019 In-hospital cardiac arrest:<\/strong> location immediately prior to source of admission to the unit is not \u2018clinic or home\u2019 Age, gender, year of admission and past medical history were extracted. Severity of Data were extracted on the proportion of people that had the following:<\/p>\n lowest temperature of???34\u00a0\u00b0C in the first 24\u00a0h (as a surrogate marker for treatment treatment withdrawn;<\/p>\n timing of treatment withdrawn.<\/p>\n Survival data were extracted at discharge from the CMP unit and at ultimate discharge Length of stay in the CMP unit was calculated in fractions of days from the dates A statistical analysis plan was agreed a priori. The analyses performed were as follows.<\/p>\n Case mix, withdrawal, outcome and activity were described annually for all admissions A multivariable logistic regression was performed to analyse the impact on outcome All analyses were repeated using only the data from those ICUs contributing data throughout All analyses were performed using Stata 13.0 (Stata Corporation, College Station, Case Mix Programme Database The Case Mix Programme (CMP) is a national comparative audit of adult, general ICUs (including intensive care units and combined intensive care and high dependency units, but not coronary care units) in England, Wales and Northern Ireland co-ordinated by ICNARC. The CMP has received approval from the Patient Information Advisory Group Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-92235","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/92235","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/comments?post=92235"}],"version-history":[{"count":0,"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/posts\/92235\/revisions"}],"wp:attachment":[{"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/media?parent=92235"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/categories?post=92235"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthmedicinet.com\/i\/wp-json\/wp\/v2\/tags?post=92235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\n and source of admission to the unit is \u2018AE, same hospital\u2019.\n <\/p>\n
\n and source of admission to the unit is not \u2018AE, same hospital\u2019.\n <\/p>\nCase mix<\/h4>\n
\n illness was measured by the ICNARC model 13<\/a>]. The ICNARC model encompasses a weighting for acute physiology (the ICNARC physiology
\n score, defined by derangement from the normal range for twelve physiological variables
\n in the first 24\u00a0hours following admission to ICU) and additionally a weighting for
\n age, diagnostic category coefficients and interactions with the physiology score,
\n cardiopulmonary resuscitation within 24\u00a0hours prior to admission, and source of admission.\n <\/p>\nTreatment<\/h4>\n
\n with therapeutic hypothermia);\n <\/p>\nOutcome<\/h4>\n
\n from an acute hospital. The proportion of survivors discharged to home was documented.
\n In those who died, the proportion who became solid organ donors was collected.\n <\/p>\nActivity<\/h4>\n
\n and times of admission and discharge. Length of stay in hospital was calculated in
\n days from the dates of original admission and ultimate discharge. Readmissions to
\n the unit within the same hospital stay were identified from the postcode, date of
\n birth and sex, and confirmed by the participating units.\n <\/p>\nStatistical analyses<\/h4>\n
Descriptive statistics<\/h4>\n
\n identified as post-cardiac arrest admissions, and separately for out-of-hospital cardiac
\n arrest and in-hospital cardiac arrest. Readmissions were included in the descriptive
\n statistics but were removed from the outcomes. To evaluate changes in study variables
\n by calendar year we used logistic regression for categorical variables and linear
\n regression for continuous, using the year of admission as the predictor variable.
\n For non-normally distributed data, we used the Jonckheere-Terpstra trend test.\n <\/p>\nMultivariable analyses<\/h4>\n
\n of year of admission. To assess whether in-hospital mortality had improved over time,
\n hierarchical multivariate logistic regression models were then constructed, with in-hospital
\n mortality as the dependent variable, year of admission as the main exposure variable
\n (modelled as continuous variable ranging from year 2004 to 2014), and ICU as a random
\n effect. Models were adjusted for illness severity and potential confounding variables,
\n including age, reason for admission and source for admission. This model estimated
\n the adjusted probability of in-hospital mortality per incremental year over the study
\n period. Separated models were developed for out-of-hospital CPR admissions and in-hospital
\n CPR admissions.\n <\/p>\n
\n the study period.\n <\/p>\n
\n TX, USA).\n <\/p>\n","protected":false},"excerpt":{"rendered":"