PURPOSE: Using sensitivity analysis to estimate the impact, in terms of patient lives, of the failure to use proven therapies known to reduce mortality in critically ill intensive care unit patients. MATERIALS AND METHODS: We identified high-impact interventions published in the last 5 years in the Journal of the American Medical Association or New England Journal of Medicine, extracted the absolute risk reduction associated with each intervention and gleaned the national incidence of each condition and the percent of the population not receiving the cited therapy from the literature. From this information, we calculated national estimates of the excess deaths from failure to use these therapies. RESULTS: With consistent and appropriate implementation of the 5 cited evidence-based interventions, we found a total of 167,819 lives could be saved per year, with a range of 137,670 to 197,965 lives saved per year. CONCLUSIONS: Mistakes of omission are common in the critical care setting and lead to significant preventable mortality. There is a significant gap between the discovery of effective interventions and their use in clinical practice. By viewing the delivery of healthcare as a science and increasing funding for health services research, we may be able to increase the use of effective therapies and, as a result, reduce patient mortality.
PURPOSE: Using sensitivity analysis to estimate the impact, in terms of patient lives, of the failure to use proven therapies known to reduce mortality in critically ill intensive care unit patients. MATERIALS AND METHODS: We identified high-impact interventions published in the last 5 years in the Journal of the American Medical Association or New England Journal of Medicine, extracted the absolute risk reduction associated with each intervention and gleaned the national incidence of each condition and the percent of the population not receiving the cited therapy from the literature. From this information, we calculated national estimates of the excess deaths from failure to use these therapies. RESULTS: With consistent and appropriate implementation of the 5 cited evidence-based interventions, we found a total of 167,819 lives could be saved per year, with a range of 137,670 to 197,965 lives saved per year. CONCLUSIONS: Mistakes of omission are common in the critical care setting and lead to significant preventable mortality. There is a significant gap between the discovery of effective interventions and their use in clinical practice. By viewing the delivery of healthcare as a science and increasing funding for health services research, we may be able to increase the use of effective therapies and, as a result, reduce patient mortality.
Authors: Jonathan P Singer; Jeffrey Kohlwes; Stephen Bent; Leslie Zimmerman; Mark D Eisner Journal: J Intensive Care Med Date: 2010-07 Impact factor: 3.510
Authors: Jan-Peter Braun; Hanswerner Bause; Frank Bloos; Götz Geldner; Marc Kastrup; Ralf Kuhlen; Andreas Markewitz; Jörg Martin; Hendrik Mende; Michael Quintel; Klaus Steinmeier-Bauer; Christian Waydhas; Claudia Spies Journal: Ger Med Sci Date: 2010-10-08
Authors: Monica S Vavilala; Mary A Kernic; Jin Wang; Nithya Kannan; Richard B Mink; Mark S Wainwright; Jonathan I Groner; Michael J Bell; Christopher C Giza; Douglas F Zatzick; Richard G Ellenbogen; Linda Ng Boyle; Pamela H Mitchell; Frederick P Rivara Journal: Crit Care Med Date: 2014-10 Impact factor: 7.598
Authors: Janessa M Graves; Nithya Kannan; Richard B Mink; Mark S Wainwright; Jonathan I Groner; Michael J Bell; Christopher C Giza; Douglas F Zatzick; Richard G Ellenbogen; Linda Ng Boyle; Pamela H Mitchell; Frederick P Rivara; Jin Wang; Ali Rowhani-Rahbar; Monica S Vavilala Journal: Pediatr Crit Care Med Date: 2016-05 Impact factor: 3.624