Stacked ICU Admissions and Mortality

This interesting study shows that when ICU admissions are stacked, that is two or more admissions come too close to each other, there is an increased risk of patient mortality, longer hospital stay, and higher odds of nursing home discharge.

Investigators enrolled 13,234 consecutive ICU admissions of which 1/4rth had an elapsed time since the last admission (ETLA) of < 55 min. Stacked admissions had on average, a higher unadjusted [1.16 (95% CI 1–1.35, P = 0.05)] and adjusted [1.23 (95% CI 1.04–1.44, P = 0.01)] odds ratio of ICU death, higher unadjusted [1.11 (95% CI 0.99–1.24, P = 0.06)] and adjusted [1.20 (95% 1.05–1.35, P = 0.004)]  odds ratio of hospital death, and a lower adjusted OR of home discharge of 0.91 (95% CI 0.84–0.99, P = 0.04).

Case against propensity scores

Here is an interesting video (couple of years old but still relevant)