Variation in length of intensive care unit stay after cardiac arrest: where you are is as important as who you are

Abstract

Objective: To determine whether hospital site is independently associated with length of intensive care unit (ICU) stay in those patients who die in hospital after experiencing a cardiac arrest.

Design: Retrospective cohort study.

Setting: Thirty-one Canadian ICUs, all but one being members of the Critical Care Research Network.

Patients: All patients admitted to these ICUs after resuscitation from a cardiac arrest.

Interventions: None.

Measurements and main results: Retrospective analysis of prospectively collected clinical data. Using gamma regression with ICU length of stay as the dependent variable, we found the following variables to be independently associated with ICU length of stay: age, gender, Acute Physiology and Chronic Health Evaluation II score, Glasgow Coma Scale score, hospital size, and hospital site.

Conclusions: In this cohort of patients admitted to ICU after cardiac arrest, hospital site was strongly associated with ICU length of stay after controlling for patient-specific factors. Variation in processes of care among ICUs may point to opportunities for improvement.