title: Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil.
abstract: OBJECTIVE
  To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units.
  
  
  METHODS
  This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student's t test, Mann-Whitney test, and logistic regression.
  
  
  RESULTS
  Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021).
  
  
  CONCLUSIONS
  Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BR.
authors.forename: Luciano Passamani
authors.initials: LP
authors.lastname: Diogo
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR.
authors.forename: Laura Fuchs
authors.initials: LF
authors.lastname: Bahlis
authors.affiliation: Serviço de Medicina Hospitalar, Hospital Montenegro, Montenegro, RS, BR.
authors.forename: André
authors.initials: A
authors.lastname: Wajner
authors.affiliation: Serviço de Medicina Hospitalar, Hospital Montenegro, Montenegro, RS, BR.
authors.forename: Fernando Starosta
authors.initials: FS
authors.lastname: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors