title: The importance of technology for achieving superior outcomes from intensive care. Brazil APACHE III Study Group.
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.
  
  
  METHODS
  Prospective multicenter descriptive cohort study.
  
  
  METHODS
  Ten Brazilian medical-surgical ICUs.
  
  
  METHODS
  1734 consecutive adult ICU admissions.
  
  
  RESULTS
  We recorded 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.
  
  
  CONCLUSIONS
  The ability of Brazilian ICUs to reduce hospital mortality is associated with the amount of technology available in these units.
authors.affiliation: Hospital de Ipanema, Rio de Janeiro, Brazil.
authors.forename: P G
authors.initials: PG
authors.lastname: Bastos
authors.forename: W A
authors.initials: WA
authors.lastname: Knaus
authors.forename: J E
authors.initials: JE
authors.lastname: Zimmerman
authors.forename: A
authors.initials: A
authors.lastname: Magalhães
authors.forename: X
authors.initials: X
authors.lastname: Sun
authors.forename: D P
authors.initials: DP
authors.lastname: Wagner
mesh_terms: D000328:Adult; D001938:Brazil; D015331:Cohort Studies; D003422:Critical Care / Q000458:organization & administration*; D004059:Diffusion of Innovation; D006295:Health Resources / Q000592:standards*; D006302:Health Services Research; D017052:Hospital Mortality; D006801:Humans; D013677:Medical Laboratory Science; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011787:Quality of Health Care