Table 2.
Patient Outcomes by Admitting Service
| ACNP (n = 2,366) | Resident (n = 6,700) | P Value | Adjusted OR | 95% CI | P Value | |
|---|---|---|---|---|---|---|
| Mortality | ||||||
| ICU mortality | 6.3% (149) | 11.6% (777) | < .001 | 0.77 | 0.63-0.94 | .01 |
| Hospital mortality | 10.0% (236) | 15.9% (1,065) | < .001 | 0.87 | 0.73-1.03 | .11 |
| UHC expected mortality | 10.4% | 15.5% | ||||
| Observed in-hospital deaths | 235 | 1,048 | ||||
| Expected in-hospital deaths | 239.5 | 1,021.7 | ||||
| O:E ratio, in-hospital deaths | 0.981 | 1.026 | ||||
| 90-d mortality | 21.6% (510) | 28.3% (1,896) | < .001 | 0.94 | 0.83-1.07 | .36 |
| Longer term mortality | 38.3% (906) | 43.0% (2,881) | < .001 | 1.03 | 0.92-1.14 | .65 |
| Length of stay | ||||||
| ICU length of stay, d | 3.4 (3.2-3.5) | 3.7 (3.6-3.8) | < .001 | 1.01 | 0.93-1.1 | .81 |
| Hospital length of stay, d | 7.9 (7.4-8.4) | 9.1 (8.8-9.3) | < .001 | 0.87 | 0.8-0.95 | < .001 |
| UHC expected length of stay, d | 7.6 | 9.0 | ||||
| ICU disposition | ||||||
| Transfer to hospital ward | 56.3% (1,250) | 69.7% (4,126) | < .001 | |||
| Discharge from hospital | 43.6% (967) | 30.3% (1,797) | < .001 | |||
| ICU readmission | ||||||
| Before hospital discharge | 3.5% (83) | 4.4% (297) | .06 | 0.92 | 0.72-1.19 | .53 |
| Within 30 d of hospital discharge | 5.5% (129) | 5.3% (352) | .75 | 1.04 | 0.84-1.28 | .75 |
ICU, hospital, 90-d, and longer term mortality are presented as percentage (frequency) and were compared between ACNP and resident teams using the Pearson χ2 test. Longer term mortality is death at any point during follow up (median duration of follow up, 231 d). UHC expected mortality, observed in-hospital deaths, expected in-hospital deaths, and O:E ratio are given for the 2,309 ACNP and 6,581 resident patients with available UHC expected mortality data. ICU and hospital length of stay are presented as mean (bootstrap estimate of 95% CI for the mean) and were compared between ACNP and resident teams using the Wilcoxon rank-sum test. The proportion of patients transferred from an ICU room to the hospital ward vs discharged directly from the ICU room to home, a skilled nursing facility, inpatient rehabilitation, hospice, inpatient psychiatric care, or jail is compared among survivors to ICU discharge on the ACNP (n = 2,217) and resident (n = 5,923) teams using the Pearson χ2 test. The proportion of patients readmitted to the ICU before hospital discharge and within 30 d of hospital discharge is compared between ACNP and resident services using the Pearson χ2 test. Binary logistic regression and proportional odds models were fit to estimate the group difference for binary and ordinal outcomes, respectively, adjusting for age, sex, ventilator use, vasopressor use, and UHC expected mortality. Compared with patients cared for by residents, ACNP patients had similar odds of a longer ICU stay (odds ratio, 1.01) and lower odds of a longer hospital stay (odds ratio, 0.87). ACNP = acute care nurse practitioner; O:E = ratio of observed in-hospital deaths to expected in-hospital deaths. See Table 1 legend for expansion of other abbreviation.