Department of Intensive Care, North Karelia Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland.
Intensive Care Med. 2010 Apr;36(4):673-9. doi: 10.1007/s00134-009-1688-9. Epub 2010 Feb 9.
To find out whether mortality from sepsis is influenced by the size of the hospital and of the intensive care unit (ICU).
In the Finnsepsis study, 470 patients with severe sepsis were identified. The present study is a retrospective subgroup analysis of the Finnsepsis study. Eighteen patients were excluded because of treatment in more than one ICU. We divided the 24 units into three groups based on hospital size and academic status.
There were no significant differences between the ICU groups in terms of severity of illness. Overall, the hospital mortality rate was 29.2%. In post-operative patients, the hospital mortality rate was 22.9% for patients treated in large ICUs (including university and large non-university hospital ICUs) but 42.3% for patients treated in small ICUs (p = 0.045). In medical patients, no differences in outcomes were found.
Treatment of surgical patients with severe sepsis in small ICUs was associated with increased mortality. Because of the relatively small sample size, further studies are needed to confirm or refute this association.
探讨医院和重症监护病房（ICU）规模对脓毒症死亡率的影响。
在芬兰脓毒症研究中，共确定了 470 例严重脓毒症患者。本研究是对芬兰脓毒症研究的回顾性亚组分析。因在多个 ICU 接受治疗而排除了 18 例患者。我们根据医院规模和学术地位将 24 个单位分为三组。
在疾病严重程度方面，ICU 之间没有明显差异。总体而言，医院死亡率为 29.2%。术后患者中，在大型 ICU（包括大学和大型非大学医院 ICU）治疗的患者的医院死亡率为 22.9%，而在小型 ICU 治疗的患者的医院死亡率为 42.3%（p=0.045）。在内科患者中，未发现结局存在差异。
在小型 ICU 中治疗外科严重脓毒症患者与死亡率增加相关。由于样本量相对较小，需要进一步的研究来证实或反驳这种关联。
