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. 2017 Jun;14(6):943–951. doi: 10.1513/AnnalsATS.201611-847OC

Table 3.

Association of intensive care unit admission on 30-day mortality for chronic obstructive pulmonary disease, heart failure, and acute myocardial infarction

Model ICU Patients Ward Patients Absolute Difference (95% CI) P Value
COPD (n = 604,894)
Unadjusted regression 22.2% 5.1% 17.1% (16.6 to 17.5) <0.001
Instrumental variable* 8.3% 8.6% −0.3% (–3.5 to 2.8) 0.84
HF (n = 626,174)
Unadjusted regression 18.2% 9.1% 9.1% (8.6 to 9.7) <0.001
Instrumental variable 12.1% 11.0% 1.1% (–0.4 to 2.6) 0.14
AMI (n = 324,729)
Unadjusted regression 17.3% 13.8% 3.5% (3.0 to 4.0) <0.001
Instrumental variable 15.9% 16.3% −0.4% (–2.2 to 1.4) 0.65

Definition of abbreviations: AMI = acute myocardial infarction; CI = confidence interval; COPD = chronic obstructive pulmonary disease; HF = heart failure; ICU = intensive care unit.

*

Model adjusted for all variables in Tables 1 and 2 in addition to all 29 individual Elixhauser comorbidities. The Angus organ failure score, which identifies severity of illness by patient organ failures derived from the administrative record with a maximum score of six, was defined to include all organ failures numbered 0 to 5 or more. Higher scores indicate more organ failures. Hospital region included the nine U.S. census defined regions. All standard errors for models were adjusted for clustering of patients within hospitals.

Two-stage least-squares regression of all patients, using differential distance to nearest high-ICU-use hospital as instrumental variable, adjusted for all variables in Tables 1 and 2, and for clustering of patients within hospitals.