Critical Illness Outcomes Study

Title: Do ICU Structural and Procedural Factors Influence Patient Related Outcomes: The Critical Illness Outcome Study (CIOS) Objectives: This is an exploratory ecologic study designed to examine the organizational and structural factors present in adult intensive care units in the United States. A second objective is to determine whether these organizational and structural factors are associated with patient related outcomes. In addition, we intend to examine whether these organizational and structural issues are associated with patient treatments. Hypotheses: (Ho) A. The number of protocols used in an ICU is inversely associated with ICU and hospital survival for critically ill patients. B. Compliance with disease specific protocols is not independently associated with hospital survival for critically ill patients Specific Aims 1. To describe the organizational structure of participating intensive care units 2. To determine whether the number of protocols used in an intensive care unit is associated with ICU and hospital survival for critically ill patients 3. To determine the frequency with which ICU's follow disease specific protocols for patients with sepsis and ALI Study Design 1. Prospective ecologic study of 50-60 adult intensive care units and admitted patients 2. ICU organizational and structural data will be collected for each participating ICU 3. 125-200 adult patients in each intensive care unit will be enrolled. Patients within the ICU on a varying, specific day each week will be included. Demographic and treatment variables will be collected for that day on that patient. Outcome data will be collected on ICU and hospital discharge.