Critical Care Resources in Guangdong Province of China: Three Surveys from 2005 to 2015*

Wu, Jianfeng; Pei, Fei; Ouyang, Bo; Chen, Juan; Li, Yimin; Feng, Yang; Guo, Fa-Liang; Zhou, Lei; Wang, Zheng; Guo, Yingjun; Lin, Qin-Han; Li, Zhanpeng; Ling, Yun; Li, Li; Deng, Liehua; Zhao, Yunhe; Dai, Jianwei; Luo, Shuyu; Zhou, D. H.; Luo, Wei-Wen; Zhao, Ling; Chen, Wei-ying; Wang, Wei-Chuan; Wenyang, Cai; Luo, Qiong-Xiang; Guan, Xiangdong

doi:10.1097/ccm.0000000000002700

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…China still faces challenges in providing optimal and equitable management strategies for ICU patients across the nation because of its broad geography and unbalanced economic development. A previous study described critical care resources in Guangdong Province [9]. Another study evaluated the practices, outcomes, and costs related to mechanical ventilation within ICUs in Beijing [10].…”

Section: Introductionmentioning

confidence: 99%

Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019

Zhen

Gao

et al. 2022

Crit Care

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Background Hospital and ICU structural factors are key factors affecting the quality of care as well as ICU patient outcomes. However, the data from China are scarce. This study was designed to investigate how differences in patient outcomes are associated with differences in hospital and ICU structure variables in China throughout 2019. Methods This was a multicenter observational study. Data from a total of 2820 hospitals were collected using the National Clinical Improvement System Data that reports ICU information in China. Data collection consisted of a) information on the hospital and ICU structural factors, including the hospital type, number of beds, staffing, among others, and b) ICU patient outcomes, including the mortality rate as well as the incidence of ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs). Generalized linear mixed models were used to analyse the association between hospital and ICU structural factors and patient outcomes. Results The median ICU patient mortality was 8.02% (3.78%, 14.35%), and the incidences of VAP, CRBSI, and CAUTI were 5.58 (1.55, 11.67) per 1000 ventilator days, 0.63 (0, 2.01) per 1000 catheter days, and 1.42 (0.37, 3.40) per 1000 catheter days, respectively. Mortality was significantly lower in public hospitals (β = − 0.018 (− 0.031, − 0.005), p = 0.006), hospitals with an ICU-to-hospital bed percentage of more than 2% (β = − 0.027 (− 0.034, -0.019), p < 0.001) and higher in hospitals with a bed-to-nurse ratio of more than 0.5:1 (β = 0.009 (0.001, 0.017), p = 0.027). The incidence of VAP was lower in public hospitals (β = − 0.036 (− 0.054, − 0.018), p < 0.001). The incidence of CRBSIs was lower in public hospitals (β = − 0.008 (− 0.014, − 0.002), p = 0.011) and higher in secondary hospitals (β = 0.005 (0.001, 0.009), p = 0.010), while the incidence of CAUTIs was higher in secondary hospitals (β = 0.010 (0.002, 0.018), p = 0.015). Conclusion This study highlights the association between specific ICU structural factors and patient outcomes. Modifying structural factors is a potential opportunity that could improve patient outcomes in ICUs.

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Section: Introductionmentioning

confidence: 99%

Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019

Zhen

Gao

et al. 2022

Crit Care

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“…A recent study conducted in China showed that the number of ICU beds per 100 000 population was only 3.69,3 which was far lower than that in European countries (11 per 100 000 population) and the USA (34 per 100 000 population) 4 5. Therefore, it is common to have ICU congestion in Chinese tertiary care hospitals resulting in patients remaining in the ED for prolonged periods of time while waiting for an ICU bed.…”

Section: Introductionmentioning

confidence: 83%

Prolonged length of stay in the emergency department and increased risk of hospital mortality in patients with sepsis requiring ICU admission

et al. 2018

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Background and objectivesDelayed patient admission to the intensive care unit (ICU) from the ED is common in China. Patients with severe sepsis or septic shock requiring ICU admission are in need of specialised monitoring and tailored treatment. Delayed admission to the ICU might be associated with adverse clinical outcomes for patients with sepsis.MethodsPatients with sepsis admitted to the ICU from the ED from January 2010 to April 2018 were retrospectively identified from a clinical data warehouse. The primary endpoint was in-hospital mortality. Length of stay in ED (EDLOS) was compared between survivors and non-survivors. A multivariable regression model was employed to adjust for potential confounding due to patient clinical condition.ResultsA total of 1997 patients, including 473 non-survivors and 1524 survivors, were included. The crude mortality rate for patients with EDLOS <6 hours was 21.4%, which was significantly lower than patients with EDLOS of 12–24 hours (31.9%), and those with EDLOS >24 hours (31.8%). After adjusting for PaO2/FiO2, serum creatinine, age, Sequential Organ Failure Assessment, body mass index, lactate, comorbidities and infection site, EDLOS continued to be independently associated with increased risk of hospital mortality. Compared with the group with EDLOS <6 hours, those with EDLOS between 12and24 hours (OR 1.82, 95% CI 1.28 to 2.58) and EDLOS >24 hours (OR 1.79, 95% CI 1.27 to 2.52) showed a significantly increased risk of death.ConclusionsOur study shows that prolonged EDLOS is independently associated with increased risk of hospital mortality in patients with sepsis requiring ICU admission.

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“…The responses obtained indicate that there has been a significant increase in the number of female ICU physicians. As the total number of ICU physicians increases year by year in China, [7] the proportion of female ICU physicians has increased in 55 hospitals (74.3%), been stable in 14 hospitals (18.9%), and decreased in 2 hospitals (2.7%); further, for 3 hospitals (4.1%) in this sample, information on the change in the proportion of female representation remains unknown. Data from the questionnaire reveal that female representation in these hospitals is 50.06% (838/1674).…”

Section: Increasing Of Female Icu Physicians In Chinamentioning

confidence: 83%

Female representation in intensive care medicine: Challenges and perspectives from China

Liao

Yang

Rubulotta

et al. 2022

Journal of Intensive Medicine

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Critical Care Resources in Guangdong Province of China: Three Surveys from 2005 to 2015*

Cited by 9 publications

References 11 publications

Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019

Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019

Prolonged length of stay in the emergency department and increased risk of hospital mortality in patients with sepsis requiring ICU admission

Female representation in intensive care medicine: Challenges and perspectives from China

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