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Original Research: CRITICAL CARE |

Benchmark Data From More Than 240,000 Adults That Reflect the Current Practice of Critical Care in the United StatesCritical Care Benchmarks

Craig M. Lilly, MD, FCCP; Ilene H. Zuckerman, PharmD, PhD; Omar Badawi, PharmD; Richard R. Riker, MD, FCCP; American College of Critical Care Medicine Task Force on Models of Critical Care Delivery. The American College of Critical Care Medicine Guidelines for the Defintion of an Intensivist and the Practice of Critical Care Medicine
Author and Funding Information

From the Department of Medicine (Dr Lilly), the Department of Anesthesiology (Dr Lilly), and the Department of Surgery (Dr Lilly), School of Medicine, and the Clinical and Population Health Research Program (Dr Lilly), Graduate School of Biomedical Sciences, University of Massachusetts Medical School, Worcester, MA; the Department of Pharmaceutical Health Services Research (Dr Zuckerman), and the Department of Pharmacy Practice and Science (Dr Badawi), University of Maryland School of Pharmacy, Baltimore, MD; Philips Healthcare (Dr Badawi), Baltimore, MD; the Department of Critical Care Medicine (Dr Riker), Maine Medical Center, Portland, ME; and Tufts Medical School (Dr Riker), Boston, MA.

Correspondence to: Craig M. Lilly, MD, FCCP, University of Massachusetts Medical School, UMass Memorial Medical Center, 281 Lincoln St, Worcester, MA 01605; e-mail: craig.lilly@umassmed.edu


For editorial comment see page 1111

Funding/Support: This study was supported by the eICU Research Institute through a contract with the University of Maryland.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(5):1232-1242. doi:10.1378/chest.11-0718
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Background:  Nationwide benchmarks representing current critical care practice for the range of ICUs are lacking. This information may highlight opportunities for care improvement and allows comparison of ICU practice data.

Methods:  Data representing 243,553 adult admissions from 271 ICUs and 188 US nonfederal hospitals during 2008 were analyzed using the eICU Research Institute clinical practice database. Participating ICUs and hospitals varied widely regarding bed number, community size, academic status, geographic location, and organizational structure.

Results:  More than one-half of these critically ill adults were < 65 years old, and most patients returned to their homes after hospital discharge. Most patients were admitted from an ED, had a medical admission diagnosis, and received antimicrobial therapy. Intensive treatment was common, including 27% who received mechanical ventilation, 7.5% who were supported with noninvasive ventilation, 24.3% who were treated with vasoactive infusions, > 20% who received a blood product, and 4.4% who agreed to a care limitation order during their ICU stay. Forty percent of cases had a < 10% mortality risk and did not have an intensive treatment documented.

Conclusions:  Admission to an ICU in 2008 involved active treatments that often included life support and counseling for those near the end of life and was associated with favorable outcomes for most patients.

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