We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one), but excluded cases of readmission during the same hospitalization. Our clinical series included 505 men (60.8%) and 518 medical patients (62.4%). The mean age of patients was 61.1±18.0 years. Length of ICU stay and the period of mechanical ventilation were presented as both median and IQR (the length of ICU stay, 4 days; range, 2~8 days; and the period of mechanical ventilation, 69 hours; range, 25.5~228.5 hours). In association with the mechanical ventilation, severity scores and variables showed that the APACHE II score at admission was 16.7±9.6 points, the SOFA score was 4.8±3.5 points, the number of patients on mechanical ventilation was 233 (28.1%) and the success rate of weaning was 49.8% (116/233). In addition, the ICU mortality rate was 12.7% (105/830). The primary reasons of ICU admission include 201 cases (24.2%) of cerebrovascular diseases, 166 cases (20%) of trauma, 158 cases (19%) of gastrointestinal and hepatobiliary diseases, 93 cases (11.2%) of cardiovascular diseases, 82 cases (9.9%) of respiratory diseases, 34 cases (4.1%) of renal or urologic diseases, 22 cases (2.7%) of metabolic or endocrinologic diseases and 74 cases (8.9%) of close monitoring. The most common underlying disease was cerebrovascular disease that was seen in 310 patients (37.3%). There were 75 patients (9%) who received a 'do-not-resuscitate (DNR)' order including withdrawal of treatment by next of kin. The CCT was activated at the total frequency of 1,246 (123 times by patients' needs, 887 times by the MERIT study criteria and 236 times by the CCT member's decision).
The baseline characteristics of the study are presented in . Sex and age were similar between the two groups. But patients of the CCT group presented more serious conditions than those of the non-CCT group (APACHE II 20.2 vs. 15.8, p<0.001; SOFA 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than the non-CCT group (45.9% vs. 23.9%, p<0.001). The CCT group had a significantly longer ICU stay than the non-CCT group (4 days vs. 3 days, p=0.015). Length of mechanical ventilation, ICU mortality and the number of DNR cases were similar between the two groups. Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). Details of clinical outcomes are shown in . There were no significant differences in unadjusted ICU mortality rates between the two groups (14% in CCT vs. 12.3% in non-CCT). However, the ICU mortality rate associated with the mechanical ventilation was significantly lower in the CCT group than the non-CCT group (26.4% in the CCT vs. 44.1% in the non-CCT groups, p=0.01). shows the baseline characteristics and clinical outcomes of patients on mechanical ventilation.
Baseline characteristics of the study (n=830)
Clinical outcomes of the study (n=830)
Baseline characteristics and clinical outcomes in patients on mechanical ventilation (n=233)
On univariate analysis, the increased ICU mortality was associated with chronic respiratory diseases, malignancy, medical patient, higher severity scores (APACHE II and SOFA), longer ICU stay and mechanical ventilation (p<0.05). On a multivariate logistic regression analysis with the adjustment of confounder, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). shows the prognostic factors associated with the ICU mortality in detail.
Prognostic factors associated with ICU mortality by multivariate logistic regression model