The effectiveness of right heart catheterization in the initial care of critically ill patients.
- To examine the association between the use of right heart catheterization (RHC) during the first 24 hours of care in the intensive care unit (ICU) and subsequent survival, length of stay, intensity of care, and cost of care.
- Prospective cohort study.
Five US teaching hospitals between 1989 and 1994.
- A total of 5735 critically ill adult patients receiving care in an ICU for 1 of 9 prespecified disease categories.
Main Outcome Measures
- survival time, cost of care, intensity of care, and length of stay in the ICU and hospital, determined from the clinical record and from the National Death Index.
A propensity score for RHC was constructed using multivariable logistic regression.
Case-matching and multivariable regression modeling techniques were used to estimate the association of RHC with specific outcomes after adjusting for treatment selection using the propensity score.
Sensitivity analysis was used to estimate the potential effect of an unidentified or missing covariate on the results.
- By case-matching analysis, patients with RHC had an increased 30-day mortality (odds ratio, 1.24 ; 95% confidence interval, 1.03-1.49).
The mean cost (25th, 50th, 75th percentiles) per hospital stay was $49300 ($17000, $30500, $56 600) with RHC and $35 700 ($11 300, $20 600, $39 200) without RHC.
Mean length of stay in the ICU was 14.8 (5,9,17) days with RHC and 13.0 (4,7,14) days without RHC. (...)
Mots-clés Pascal : Cathétérisme, Coeur droit, Réanimation cardiocirculatoire, Cardiopathie, Aigu, Appareil respiratoire pathologie, Coût, Etats Unis, Amérique du Nord, Amérique, Survie, Pronostic, Homme, Réanimation, Appareil circulatoire pathologie, Economie santé, Durée sejour
Mots-clés Pascal anglais : Catheterization, Right heart, Intensive cardiocirculatory care, Heart disease, Acute, Respiratory disease, Costs, United States, North America, America, Survival, Prognosis, Human, Resuscitation, Cardiovascular disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0435210
Code Inist : 002B27B01. Création : 10/04/1997.