The importance of technology for achieving superior outcomes from intensive care. Brazil APACHE III Study Group.
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.
Bastos
P G
PG
Hospital de Ipanema, Rio de Janeiro, Brazil.
Knaus
W A
WA
Zimmerman
J E
JE
Magalhães
A
A
Sun
X
X
Wagner
D P
DP
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