Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea
Background Sepsis is a leading cause of intensive care unit (ICU) admission. However, few studies have evaluated how the ICU model affects the outcomes of patients with sepsis. Methods This post hoc analysis of data from the Management of Severe Sepsis in Asia’s Intensive Care Units II study include...
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Korean Society of Critical Care Medicine
2025-05-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://accjournal.org/upload/pdf/acc-004128.pdf |
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| author | Kyeongman Jeon Jin Hyoung Kim Kyung Chan Kim Heung Bum Lee Hongyeul Lee Song I Lee Jin-Won Huh Won Gun Kwack Youjin Chang Yun-Seong Kang Won Yeon Lee Je Hyeong Kim on behalf of the MOSAICS II Study Group of Korean Society of Critical Care Medicine |
| author_facet | Kyeongman Jeon Jin Hyoung Kim Kyung Chan Kim Heung Bum Lee Hongyeul Lee Song I Lee Jin-Won Huh Won Gun Kwack Youjin Chang Yun-Seong Kang Won Yeon Lee Je Hyeong Kim on behalf of the MOSAICS II Study Group of Korean Society of Critical Care Medicine |
| author_sort | Kyeongman Jeon |
| collection | DOAJ |
| description | Background Sepsis is a leading cause of intensive care unit (ICU) admission. However, few studies have evaluated how the ICU model affects the outcomes of patients with sepsis. Methods This post hoc analysis of data from the Management of Severe Sepsis in Asia’s Intensive Care Units II study included 537 patients with sepsis admitted to 27 ICUs in Korea. The outcome measures of interest were compared between the closed ICU group, patients admitted under the full responsibility of an intensivist as the primary attending physician, and the open ICU group. The association between a closed ICU and ICU mortality was evaluated using a logistic regression analysis. Results Altogether, 363 and 174 enrolled patients were treated in open and closed ICUs, respectively. Compliance with the sepsis bundles did not differ between the two groups; however, the closed ICU group had a higher rate of renal replacement therapy and shorter duration of ventilator support. The closed ICU group also had a lower ICU mortality rate than the open ICU group (24.7% vs. 33.1%). In a logistic regression analysis, management in the closed ICU was significantly associated with a decreased ICU mortality rate even after adjusting for potential confounding factors (adjusted odds ratio, 0.576; 95% CI, 0.342–0.970), and that association was observed for up to 90 days. Conclusions Sepsis management in closed ICUs was significantly associated with improved ICU survival and decreased length of ICU stay, even though the compliance rates for the sepsis bundles did not differ between open and closed ICUs. |
| format | Article |
| id | doaj-art-e51a6c7520504a2baf1b6109d57589e8 |
| institution | DOAJ |
| issn | 2586-6052 2586-6060 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj-art-e51a6c7520504a2baf1b6109d57589e82025-08-20T03:22:58ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-05-0140220922010.4266/acc.0041281597Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South KoreaKyeongman Jeon0Jin Hyoung Kim1Kyung Chan Kim2Heung Bum Lee3Hongyeul Lee4Song I Lee5Jin-Won Huh6Won Gun Kwack7Youjin Chang8Yun-Seong Kang9Won Yeon Lee10Je Hyeong Kim11on behalf of the MOSAICS II Study Group of Korean Society of Critical Care Medicine Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Internal Medicine, Daegu Catholic University Hospital, Daegu, Korea Department of Internal Medicine, Research Center for Pulmonary Disorders, Jeonbuk National University Medical School and Hospital, Jeonju, Korea Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea Division of Pulmonology and Critical Care Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, KoreaBackground Sepsis is a leading cause of intensive care unit (ICU) admission. However, few studies have evaluated how the ICU model affects the outcomes of patients with sepsis. Methods This post hoc analysis of data from the Management of Severe Sepsis in Asia’s Intensive Care Units II study included 537 patients with sepsis admitted to 27 ICUs in Korea. The outcome measures of interest were compared between the closed ICU group, patients admitted under the full responsibility of an intensivist as the primary attending physician, and the open ICU group. The association between a closed ICU and ICU mortality was evaluated using a logistic regression analysis. Results Altogether, 363 and 174 enrolled patients were treated in open and closed ICUs, respectively. Compliance with the sepsis bundles did not differ between the two groups; however, the closed ICU group had a higher rate of renal replacement therapy and shorter duration of ventilator support. The closed ICU group also had a lower ICU mortality rate than the open ICU group (24.7% vs. 33.1%). In a logistic regression analysis, management in the closed ICU was significantly associated with a decreased ICU mortality rate even after adjusting for potential confounding factors (adjusted odds ratio, 0.576; 95% CI, 0.342–0.970), and that association was observed for up to 90 days. Conclusions Sepsis management in closed ICUs was significantly associated with improved ICU survival and decreased length of ICU stay, even though the compliance rates for the sepsis bundles did not differ between open and closed ICUs.http://accjournal.org/upload/pdf/acc-004128.pdfintensive care unitorganization and administrationpatient care bundlessepsistreatment outcome |
| spellingShingle | Kyeongman Jeon Jin Hyoung Kim Kyung Chan Kim Heung Bum Lee Hongyeul Lee Song I Lee Jin-Won Huh Won Gun Kwack Youjin Chang Yun-Seong Kang Won Yeon Lee Je Hyeong Kim on behalf of the MOSAICS II Study Group of Korean Society of Critical Care Medicine Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea Acute and Critical Care intensive care unit organization and administration patient care bundles sepsis treatment outcome |
| title | Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea |
| title_full | Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea |
| title_fullStr | Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea |
| title_full_unstemmed | Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea |
| title_short | Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea |
| title_sort | closed intensive care units and sepsis patient outcomes a secondary analysis of data from a multicenter prospective observational study in south korea |
| topic | intensive care unit organization and administration patient care bundles sepsis treatment outcome |
| url | http://accjournal.org/upload/pdf/acc-004128.pdf |
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