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Variations in Case-Mix–Adjusted Duration of Mechanical Ventilation Among ICUs*
Kramer, Andrew A. PhD; Gershengorn, Hayley B. MD; Wunsch, Hannah MD, MSc; Zimmerman, Jack E. MD, FCCM, Critical Care Medicine, June 2016

The author's objectives were to develop a model that predicts the duration of mechanical ventilation and then to use this model to
compare observed versus expected duration of mechanical ventilation across ICUs. The setting included eighty-six eligible ICUs at 48 U.S. hospitals,

with ICU patients receiving mechanical ventilation on day 1 (n = 56,336) admitted from January 2013 to September 2014.

Measurements and Main Results: We developed and validated a multivariable logistic regression model for predicting duration of mechanical ventilation using ICU day 1 patient characteristics. Mean observed minus expected duration of mechanical ventilation was then obtained across patients and for each ICU. The accuracy of the model was assessed using R2. We defined better performing units as ICUs that had an observed minus expected duration of mechanical ventilation less than –0.5 days and a p value of less than 0.01; and poorer performing units as ICUs with an observed  minus expected duration of mechanical ventilation greater than +0.5 days and a p value of less than 0.01.  For the rest of the study, click here to receive a copy.


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