|
Country characteristics
|
|
Number of ICU beds/100.000 inhabitants
|
13.8 (11.6–15.9)
|
11.6 (6.4–15.9)
|
11.6 (6.4–15.9)
|
0.001
|
|
Geographical region
|
< 0.001
|
|
Central Europe
|
15 (12.8%)
|
40 (14.8%)
|
147 (11.7%)
|
|
Northern Europe
|
7 (6.0%)
|
27 (10.0%)
|
257 (20.5%)
|
|
Southern Europe
|
7 (6.0%)
|
32 (11.9%)
|
98 (7.8%)
|
|
Western Europe/USA
|
88 (75.2%)
|
171 (63.3%)
|
752 (60.0%)
|
|
Hospital characteristics
|
|
Hospital type
|
0.002
|
|
Public
|
20 (17.1%)
|
47 (17.4%)
|
318 (25.4%)
|
|
Private
|
10 (8.5%)
|
7 (2.6%)
|
77 (6.1%)
|
|
University-affiliated
|
28 (23.9%)
|
43 (15.9%)
|
178 (14.2%)
|
|
University
|
59 (50.4%)
|
173 (64.1%)
|
681 (54.3%)
|
|
Total beds in hospital
|
< 0.001
|
|
< 250
|
20 (17.1%)
|
17 (6.3%)
|
85 (6.8%)
|
|
250–499
|
33 (28.2%)
|
58 (21.5%)
|
271 (21.6%)
|
|
500–749
|
15 (12.8%)
|
70 (25.9%)
|
336 (26.8%)
|
|
> 750
|
49 (41.9%)
|
125 (46.3%)
|
562 (44.8%)
|
|
ICU characteristics
|
|
Ethical climate
|
0.13
|
|
Good
|
26 (22.2%)
|
54 (20.0%)
|
241 (19.2%)
|
|
Average +
|
48 (41.0%)
|
97 (35.9%)
|
552 (44.0%)
|
|
Poor
|
43 (36.8%)
|
119 (44.1%)
|
461 (36.8%)
|
|
Number of beds per ICU
|
12 (8–22)
|
12.5 (10–25)
|
14 (10–24)
|
0.02
|
|
Patient-to-nurse ratio
|
2 (2–2)
|
2 (1.4–3)
|
2 (1.3–3)
|
0.04
|
|
Patient-to-junior physician ratio
|
5 (3–7)
|
4 (3–6)
|
4 (3–6)
|
0.09
|
|
Patient-to-senior physician ratio
|
7 (6–8)
|
7 (5–8)
|
7 (4–8)
|
0.08
|
|
Percentage of population > 65 year in ICUa
|
18 (18–18)
|
18 (18–18)
|
18 (18–18)
|
< 0.001
|
|
Patient characteristics
|
|
Age
|
66 (58–73)
|
67 (57–75)
|
63 (50–74)
|
0.002
|
|
Gender
|
63 (53.8)%
|
171 (63.3)%
|
736 (58.7)%
|
0.18
|
|
ECOG performance status
|
< 0.001
|
|
Grade 0
|
20 (17.1%)
|
78 (28.9%)
|
475 (37.9%)
|
|
Grade 1
|
30 (25.6%)
|
89 (33.0%)
|
285 (22.7%)
|
|
Grade 2
|
26 (22.2%)
|
45 (16.7%)
|
169 (13.5%)
|
|
Grade 3
|
21 (17.9%)
|
27 (10.0%)
|
156 (12.4%)
|
|
Grade 4
|
9 (7.7%)
|
16 (5.9%)
|
57 (4.5%)
|
|
Unknown
|
11 (9.4%)
|
15 (5.6%)
|
112 (8.9%)
|
|
Nursing home resident
|
3 (2.6%)
|
6 (2.2%)
|
69 (5.5%)
|
0.03
|
|
Moderate-to-severe comorbidities
|
< 0.001
|
|
0
|
0 (0.0%)
|
0 (0.0%)
|
790 (63.0%)
|
|
1
|
90 (76.9%)
|
197 (73.0%)
|
379 (30.2%)
|
|
≥ 2
|
27 (23.1%)
|
73 (23.0%)
|
85 (6.8%)
|
|
Type comorbidity
|
|
Heart failure (NYHA III or IV)
|
5 (4.3%)
|
21 (7.8%)
|
166 (13.2%)
|
< 0.001
|
|
COPD (Gold III or IV or equivalent)
|
12 (10.3%)
|
35 (13.0%)
|
143 (11.4%)
|
0.69
|
|
Neurological (excluding dementia)
|
7 (6.0%)
|
7 (2.6%)
|
89 (7.1%)
|
0.02
|
|
Liver cirrhosis (Child–Pugh B or C)
|
0 (0.0%)
|
10 (3.7%)
|
72 (5.7%)
|
< 0.001
|
|
Chronic renal failure requiring dialysis
|
4 (3.4%)
|
4 (1.5%)
|
46 (3.7%)
|
0.16
|
|
Dementia (moderate or severe)
|
1 (0.9%)
|
6 (2.2%)
|
32 (2.6%)
|
0.67
|
|
AIDS
|
0 (0.0%)
|
1 (0.4%)
|
13 (1.0%)
|
< 0.001
|
|
Abuse
|
|
Alcohol
|
1 (0.9%)
|
14 (5.2%)
|
166 (13.2%)
|
< 0.001
|
|
Smoking
|
10 (8.5%)
|
39 (14.4%)
|
241 (19.2%)
|
0.005
|
|
Main admission reason
|
|
Respiratory failure
|
36 (30.8%)
|
65 (24.1%)
|
289 (23.0%)
|
0.17
|
|
Sepsis/severe sepsis/septic shock
|
34 (29.1%)
|
67 (24.8%)
|
222 (17.7%)
|
< 0.001
|
|
Heart failure/cardiogenic shock
|
11 (9.4%)
|
24 (8.9%)
|
244 (19.5%)
|
< 0.001
|
|
Neurologic pathology/stroke/ICB
|
8 (6.8%)
|
17 (6.3%)
|
157 (12.5%)
|
0.002
|
|
Gastro-intestinal pathology/liver failure
|
10 (8.5%)
|
26 (9.6%)
|
133 (10.6%)
|
0.72
|
|
Metabolic/renal
|
14 (12.0%)
|
22 (8.1%)
|
108 (8.6%)
|
0.44
|
|
Multiple trauma
|
0 (0.0%)
|
4 (1.5%)
|
92 (7.3%)
|
< 0.001
|
|
Head trauma
|
1 (0.9%)
|
2 (0.7%)
|
55 (4.4%)
|
0.003
|
|
Surgery within 48 h
|
38 (32.5%)
|
122 (45.2%)
|
100 (31.9%)
|
< 0.001
|
|
Surgery
|
< 0.001
|
|
No surgery
|
79 (67.5%)
|
141 (52.2%)
|
850 (67.8%)
|
|
Scheduled surgery
|
19 (16.2%)
|
77 (28.5%)
|
111 (8.9%)
|
|
Unscheduled surgery
|
19 (16.2%)
|
52 (19.3%)
|
293 (23.4%)
|
|
Do-not-resuscitate order before ICU admission
|
< 0.001
|
|
Full code
|
87 (74.4%)
|
224 (90.4%)
|
1132 (90.3%)
|
|
Unknown
|
8 (6.8%)
|
10 (3.7%)
|
57 (4.5%)
|
|
No CPR
|
14 (12.0%)
|
13 (4.8%)
|
34 (2.7%)
|
|
Withholding therapy
|
8 (6.8%)
|
3 (1.1%)
|
31 (2.5%)
|
|
Severity of illness < 24 h after admission
|
|
Invasive mechanical ventilation
|
42 (35.9%)
|
126 (46.7%)
|
616 (49.1%)
|
0.02
|
|
Vasopressor need
|
34 (29.1%)
|
106 (39.3%)
|
443 (35.3%)
|
0.15
|
|
Dialysis
|
3 (2.6%)
|
5 (1.9%)
|
47 (3.7%)
|
0.31
|
|
Written withholding/withdrawing order < 24 h
|
11 (9.4%)
|
6 (2.2%)
|
50 (4.0%)
|
0.008
|
|
Characteristics during ICU stay
|
|
Non-missing patients
|
n = 93
|
n = 253
|
n = 1165
|
0.20
|
|
Invasive mechanical ventilation
|
46 (49.5%)
|
143 (56.5%)
|
684 (58.7%)
|
|
Duration of invasive ventilation
|
3 (1–7)
|
2 (1–6)
|
2 (1–6)
|
0.36
|
|
Vasopressor need
|
42 (45.2%)
|
130 (51.4%)
|
544 (46.7%)
|
|
Duration of vasopressors
|
3 (1–5)
|
2 (1–4)
|
2 (1–4)
|
0.67
|
|
Dialysis
|
5 (5.4%)
|
21 (8.3%)
|
97 (8.3%)
|
|
Duration of dialysis
|
3 (3–10)
|
5 (3–8)
|
3 (1–7)
|
0.26
|
|
Length of ICU stay
|
3.6 (1.6–7.7)
|
3.8 (1.9–8.0)
|
3.2 (1.6–7.9)
|
