Pub Date : 2020-02-01Epub Date: 2019-09-16DOI: 10.1007/s12630-019-01476-8
Nicholas A Fergusson, Steve Ahkioon, Mahesh Nagarajan, Eric Park, Yichuan Ding, Najib Ayas, Vinay K Dhingra, Dean R Chittock, Donald E G Griesdale
Purpose: There is conflicting evidence regarding the influence of intensive care unit (ICU) occupancy at the time of admission on important patient outcomes such as mortality. The objective of this analysis was to characterize the association between ICU occupancy at the time of ICU admission and subsequent mortality.
Methods: This single-centre, retrospective cohort study included all patients admitted to the ICU at the Vancouver General Hospital between 4 January 2010 and 8 October 2017. Intensive care unit occupancy was defined as the number of ICU bed hours utilized in a day divided by the total amount of ICU bed hours available for that day. We constructed mixed-effects logistic regression models controlling for relevant covariates to assess the impact of admission occupancy quintiles on total inpatient (ICU and ward) and early (72-hr) ICU mortality.
Results: This analysis included 10,365 ICU admissions by 8,562 unique patients. Compared with ICU admissions in the median occupancy quintile, admissions in the highest and second highest occupancy quintile were associated with a significant increase in the odds of inpatient mortality (highest: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.12 to 1.59; P value < 0.001; second highest: OR, 1.21; 95% CI, 1.02 to 1.44; P value < 0.03). No association between admission occupancy and 72-hr ICU mortality was observed.
Conclusions: Admission to the ICU on days of high occupancy was associated with increased inpatient mortality, but not with increased 72-hr ICU mortality. Capacity strain on the ICU may result in significant negative consequences for patients, but further research is needed to fully characterize the complex effects of capacity strain.
{"title":"Association of intensive care unit occupancy during admission and inpatient mortality: a retrospective cohort study.","authors":"Nicholas A Fergusson, Steve Ahkioon, Mahesh Nagarajan, Eric Park, Yichuan Ding, Najib Ayas, Vinay K Dhingra, Dean R Chittock, Donald E G Griesdale","doi":"10.1007/s12630-019-01476-8","DOIUrl":"10.1007/s12630-019-01476-8","url":null,"abstract":"<p><strong>Purpose: </strong>There is conflicting evidence regarding the influence of intensive care unit (ICU) occupancy at the time of admission on important patient outcomes such as mortality. The objective of this analysis was to characterize the association between ICU occupancy at the time of ICU admission and subsequent mortality.</p><p><strong>Methods: </strong>This single-centre, retrospective cohort study included all patients admitted to the ICU at the Vancouver General Hospital between 4 January 2010 and 8 October 2017. Intensive care unit occupancy was defined as the number of ICU bed hours utilized in a day divided by the total amount of ICU bed hours available for that day. We constructed mixed-effects logistic regression models controlling for relevant covariates to assess the impact of admission occupancy quintiles on total inpatient (ICU and ward) and early (72-hr) ICU mortality.</p><p><strong>Results: </strong>This analysis included 10,365 ICU admissions by 8,562 unique patients. Compared with ICU admissions in the median occupancy quintile, admissions in the highest and second highest occupancy quintile were associated with a significant increase in the odds of inpatient mortality (highest: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.12 to 1.59; P value < 0.001; second highest: OR, 1.21; 95% CI, 1.02 to 1.44; P value < 0.03). No association between admission occupancy and 72-hr ICU mortality was observed.</p><p><strong>Conclusions: </strong>Admission to the ICU on days of high occupancy was associated with increased inpatient mortality, but not with increased 72-hr ICU mortality. Capacity strain on the ICU may result in significant negative consequences for patients, but further research is needed to fully characterize the complex effects of capacity strain.</p>","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"16 1","pages":"213-224"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s12630-019-01476-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75602395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-10-01DOI: 10.7861/clinmedicine.16-5-451
Lucy Lamb, David Lowe
We present the case of a man with a history of migraines treated with propanolol, referred with a rash, diarrhoea, vomiting and hypotension. Our case highlights how prior beta-blocker use may prolong anaphylaxis and cause refractory hypotension.
{"title":"A new urticarial rash, diarrhoea and refractory hypotension in a man with a history of migraines.","authors":"Lucy Lamb, David Lowe","doi":"10.7861/clinmedicine.16-5-451","DOIUrl":"10.7861/clinmedicine.16-5-451","url":null,"abstract":"<p><p>We present the case of a man with a history of migraines treated with propanolol, referred with a rash, diarrhoea, vomiting and hypotension. Our case highlights how prior beta-blocker use may prolong anaphylaxis and cause refractory hypotension.</p>","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"10 1","pages":"451-452"},"PeriodicalIF":4.4,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77767294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-12-01DOI: 10.1016/0090-5720(90)90027-5
Masoud Hemmasi, Lee A. Graf, Calvin E. Kellogg
{"title":"Industry structure, competitive rivalry, and firm profitability","authors":"Masoud Hemmasi, Lee A. Graf, Calvin E. Kellogg","doi":"10.1016/0090-5720(90)90027-5","DOIUrl":"10.1016/0090-5720(90)90027-5","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 4","pages":"Pages 431-448"},"PeriodicalIF":0.0,"publicationDate":"1990-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90027-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53977878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-12-01DOI: 10.1016/0090-5720(90)90022-Y
R. Edward Freeman, William M. Evan
{"title":"Corporate governance: A stakeholder interpretation","authors":"R. Edward Freeman, William M. Evan","doi":"10.1016/0090-5720(90)90022-Y","DOIUrl":"10.1016/0090-5720(90)90022-Y","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 4","pages":"Pages 337-359"},"PeriodicalIF":0.0,"publicationDate":"1990-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90022-Y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53977566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-12-01DOI: 10.1016/0090-5720(90)90023-Z
Lee E. Preston, Harry J. Sapienza
{"title":"Stakeholder management and corporate performance","authors":"Lee E. Preston, Harry J. Sapienza","doi":"10.1016/0090-5720(90)90023-Z","DOIUrl":"10.1016/0090-5720(90)90023-Z","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 4","pages":"Pages 361-375"},"PeriodicalIF":0.0,"publicationDate":"1990-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90023-Z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53977143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-12-01DOI: 10.1016/0090-5720(90)90024-2
Glenn E. Snelbecker, Michael J. Roszkowski, Neal E. Cutler
{"title":"Investors' risk tolerance and return aspirations, and financial advisors' interpretations: A conceptual model and exploratory data","authors":"Glenn E. Snelbecker, Michael J. Roszkowski, Neal E. Cutler","doi":"10.1016/0090-5720(90)90024-2","DOIUrl":"10.1016/0090-5720(90)90024-2","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 4","pages":"Pages 377-393"},"PeriodicalIF":0.0,"publicationDate":"1990-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90024-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53977219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-12-01DOI: 10.1016/0090-5720(90)90026-4
T.Y. Shen
{"title":"Transaction costs, behavior modes, and Chinese reform","authors":"T.Y. Shen","doi":"10.1016/0090-5720(90)90026-4","DOIUrl":"10.1016/0090-5720(90)90026-4","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 4","pages":"Pages 413-430"},"PeriodicalIF":0.0,"publicationDate":"1990-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90026-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53977335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1990-09-01DOI: 10.1016/0090-5720(90)90032-3
Jerald Hage
{"title":"Organizational theory and the problem of the shift in the Phillips Curve","authors":"Jerald Hage","doi":"10.1016/0090-5720(90)90032-3","DOIUrl":"10.1016/0090-5720(90)90032-3","url":null,"abstract":"","PeriodicalId":85718,"journal":{"name":"The Journal of behavioral economics","volume":"19 3","pages":"Pages 285-304"},"PeriodicalIF":0.0,"publicationDate":"1990-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/0090-5720(90)90032-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53363535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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