Interventions to reduce mortality among patients treated in Intensive Care Units☆
Section snippets
Study design
To achieve our aims, we conducted a literature review. We identified interventions published in the Journal of the American Medical Association or the New England Journal of Medicine estimated how often people in the United States received these therapies, and calculated national estimates of the excess deaths from failure to use these therapies. Our goal was not to identify every intervention known to improve mortality in critically ill patients but rather to identify significant interventions
Results
Our literature review identified 89 abstracts and we included 5 studies (4 randomized trials and 1 systematic review) in our analysis that met inclusion criteria and are widely accepted.16, 20, 29 We summarize these studies in Table 1.
Table 2 lists the number of patients at risk in the United States, the percentage of patients not receiving a given intervention, the number of patients needed to treat in order to prevent 1 death, and the preventable deaths in the United States annually. Our
Discussion
The Institute of Medicine report “To Err is Human” suggested between 44,000 and 98,000 people die each year in the United States because of medical errors.33 These estimates are based in general on mistakes of commission, things caregivers do to patients, and did not include mistakes of omission– the failure to use therapies we ought to. Our study suggests that mistakes of omission may pose a much greater threat to patient safety. We found that consistent and appropriate implementation of 5
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P. J. P. is supported by a grant from the VHA Foundation to develop measures of quality sepsis care. S. B. is supported by a grant from VHA Foundation for Sepsis Measures.