Tags

Type your tag names separated by a space and hit enter

The effect of race and ethnicity on outcomes among patients in the intensive care unit: a comprehensive study involving socioeconomic status and resuscitation preferences.
Crit Care Med. 2011 Mar; 39(3):429-35.CC

Abstract

OBJECTIVE

We sought to determine whether race or ethnicity is independently associated with mortality or intensive care unit length of stay among critically ill patients after accounting for patients' clinical and demographic characteristics including socioeconomic status and resuscitation preferences.

DESIGN

Historical cohort study of patients hospitalized in intensive care units.

SETTING

Adult intensive care units in 35 California hospitals during the years 2001-2004.

PATIENTS

A total of 9,518 intensive care unit patients (6,334 white, 655 black, 1,917 Hispanic, and 612 Asian/Pacific Islander patients).

MEASUREMENTS AND MAIN RESULTS

The primary outcome was risk-adjusted mortality and a secondary outcome was risk-adjusted intensive care unit length of stay. Crude hospital mortality was 15.9% among the entire cohort. Asian patients had the highest crude hospital mortality at 18.6% and black patients had the lowest at 15.0%. After adjusting for age and gender, Hispanic and Asian patients had a higher risk of death compared to white patients, but these differences were not significant after additional adjustment for severity of illness. Black patients had more acute physiologic derangements at intensive care unit admission and longer unadjusted intensive care unit lengths of stay. Intensive care unit length of stay was not significantly different among racial/ethnic groups after adjustment for demographic, clinical, and socioeconomic factors and do-not-resuscitate status. In an analysis restricted only to those who died, decedent black patients averaged 1.1 additional days in the intensive care unit (95% confidence interval, 0.26-2.6) compared to white patients who died, although this was not statistically significant.

CONCLUSIONS

Hospital mortality and intensive care unit length of stay did not differ by race or ethnicity among this diverse cohort of critically ill patients after adjustment for severity of illness, resuscitation status, socioeconomic status, insurance status, and admission type. Black patients had more acute physiologic derangements at intensive care unit admission and were less likely to have a do-not-resuscitate order. These results suggest that among intensive care unit patients, there are no racial or ethnic differences in mortality within individual hospitals. If disparities in intensive care unit care exist, they may be explained by differences in the quality of care provided by hospitals that serve high proportions of minority patients.

Authors+Show Affiliations

Division of Pulmonary and Critical Care, Kaiser Permanente, Atlanta, GA, USA. sara.erickson@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21187746

Citation

Erickson, Sara E., et al. "The Effect of Race and Ethnicity On Outcomes Among Patients in the Intensive Care Unit: a Comprehensive Study Involving Socioeconomic Status and Resuscitation Preferences." Critical Care Medicine, vol. 39, no. 3, 2011, pp. 429-35.
Erickson SE, Vasilevskis EE, Kuzniewicz MW, et al. The effect of race and ethnicity on outcomes among patients in the intensive care unit: a comprehensive study involving socioeconomic status and resuscitation preferences. Crit Care Med. 2011;39(3):429-35.
Erickson, S. E., Vasilevskis, E. E., Kuzniewicz, M. W., Cason, B. A., Lane, R. K., Dean, M. L., Rennie, D. J., & Dudley, R. A. (2011). The effect of race and ethnicity on outcomes among patients in the intensive care unit: a comprehensive study involving socioeconomic status and resuscitation preferences. Critical Care Medicine, 39(3), 429-35. https://doi.org/10.1097/CCM.0b013e318206b3af
Erickson SE, et al. The Effect of Race and Ethnicity On Outcomes Among Patients in the Intensive Care Unit: a Comprehensive Study Involving Socioeconomic Status and Resuscitation Preferences. Crit Care Med. 2011;39(3):429-35. PubMed PMID: 21187746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of race and ethnicity on outcomes among patients in the intensive care unit: a comprehensive study involving socioeconomic status and resuscitation preferences. AU - Erickson,Sara E, AU - Vasilevskis,Eduard E, AU - Kuzniewicz,Michael W, AU - Cason,Brian A, AU - Lane,Rondall K, AU - Dean,Mitzi L, AU - Rennie,Deborah J, AU - Dudley,R Adams, PY - 2010/12/29/entrez PY - 2010/12/29/pubmed PY - 2011/4/7/medline SP - 429 EP - 35 JF - Critical care medicine JO - Crit Care Med VL - 39 IS - 3 N2 - OBJECTIVE: We sought to determine whether race or ethnicity is independently associated with mortality or intensive care unit length of stay among critically ill patients after accounting for patients' clinical and demographic characteristics including socioeconomic status and resuscitation preferences. DESIGN: Historical cohort study of patients hospitalized in intensive care units. SETTING: Adult intensive care units in 35 California hospitals during the years 2001-2004. PATIENTS: A total of 9,518 intensive care unit patients (6,334 white, 655 black, 1,917 Hispanic, and 612 Asian/Pacific Islander patients). MEASUREMENTS AND MAIN RESULTS: The primary outcome was risk-adjusted mortality and a secondary outcome was risk-adjusted intensive care unit length of stay. Crude hospital mortality was 15.9% among the entire cohort. Asian patients had the highest crude hospital mortality at 18.6% and black patients had the lowest at 15.0%. After adjusting for age and gender, Hispanic and Asian patients had a higher risk of death compared to white patients, but these differences were not significant after additional adjustment for severity of illness. Black patients had more acute physiologic derangements at intensive care unit admission and longer unadjusted intensive care unit lengths of stay. Intensive care unit length of stay was not significantly different among racial/ethnic groups after adjustment for demographic, clinical, and socioeconomic factors and do-not-resuscitate status. In an analysis restricted only to those who died, decedent black patients averaged 1.1 additional days in the intensive care unit (95% confidence interval, 0.26-2.6) compared to white patients who died, although this was not statistically significant. CONCLUSIONS: Hospital mortality and intensive care unit length of stay did not differ by race or ethnicity among this diverse cohort of critically ill patients after adjustment for severity of illness, resuscitation status, socioeconomic status, insurance status, and admission type. Black patients had more acute physiologic derangements at intensive care unit admission and were less likely to have a do-not-resuscitate order. These results suggest that among intensive care unit patients, there are no racial or ethnic differences in mortality within individual hospitals. If disparities in intensive care unit care exist, they may be explained by differences in the quality of care provided by hospitals that serve high proportions of minority patients. SN - 1530-0293 UR - https://www.unboundmedicine.com/medline/citation/21187746/The_effect_of_race_and_ethnicity_on_outcomes_among_patients_in_the_intensive_care_unit:_a_comprehensive_study_involving_socioeconomic_status_and_resuscitation_preferences_ L2 - https://dx.doi.org/10.1097/CCM.0b013e318206b3af DB - PRIME DP - Unbound Medicine ER -