title: Key performance indicators in intensive care medicine. A retrospective matched cohort study.
abstract: Expert panel consensus was used to develop evidence-based process indicators that were independent risk factors for the main clinical outcome parameters of length of stay in the intensive care unit (ICU) and mortality. In a retrospective, matched data analysis of patients from five ICUs at a tertiary university hospital, agreed process indicators (sedation monitoring, pain monitoring, mean arterial pressure [MAP] >or= 60 mmHg, tidal volume [TV] <or= 6 ml/kg body weight, peak inspiratory pressure [PIP] <or= 35 cmH(2)O and blood glucose [BG] >or= 80 and <or= 130 mg/dl) were validated using a prospective dataset of 4445 consecutive patients. After matching for age, sex and ICU, 634 patients were analysed. Logistic regression of the 634 patients showed that monitoring analgesia and sedation, MAP >or= 60 mmHg and BG >or= 80 mg/dl were relevant for survival. Linear regression of the 634 patients showed that analgesia monitoring, PIP <or= 35 cmH(2)O and TV <or= 6 ml/kg were associated with reduced length of ICU stay. Linear regression on all 4445 patients showed analgesia, sedation monitoring, MAP >or= 60 mmHg, BG >or= 80 mg/dl and <or= 130 mg/dl, PIP <or= 35 cmH(2)O and TV <or= 6 ml/kg were associated with reduced length of ICU stay, indicating that adherence to evidence-based key process indicators may reduce mortality and length of ICU stay.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Campus Virchow-Klinikum and Campus Charité Mitte, Charité University Medicine Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kastrup
authors.forename: V
authors.initials: V
authors.lastname: von Dossow
authors.forename: M
authors.initials: M
authors.lastname: Seeling
authors.forename: R
authors.initials: R
authors.lastname: Ahlborn
authors.forename: A
authors.initials: A
authors.lastname: Tamarkin
authors.forename: P
authors.initials: P
authors.lastname: Conroy
authors.forename: W
authors.initials: W
authors.lastname: Boemke
authors.forename: K-D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000368:Aged; D000698:Analgesia; D016022:Case-Control Studies; D015331:Cohort Studies; D003422:Critical Care / Q000592:standards*; D054810:Deep Sedation; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012189:Retrospective Studies