The SCCM US ICU Registry Working Group
Dr
Duke University, United States
Disclosure information not submitted.
Title: Systematic Review of the Epidemiology and Delivery of Critical Care on a National Level
Introduction/Hypothesis: Several medical and surgical specialties maintain validated nationwide epidemiologic and outcomes-centered databases in the US that have demonstrably helped improve quality of care. Critical Care, however, is lacking such a program. The long-term goal of this SCCM-sponsored Research Committee endeavor is to develop a national U.S. Intensive Care Unit (ICU) registry. With the current project, we review available reports from established nationwide databases describing patterns of critical care delivery in other countries.
Methods: To determine the variables commonly recorded by nationwide ICU registries in other countries, a systematic search and review of available literature was conducted. PubMed, EMBASE and Web of Science were queried. Projects describing nationwide critical care delivery (of any subspecialty) at the unit-level that have been published in English were included. Reviews, administrative or ICU-subpopulation databases, and registries with episodes of care without ICU admission were excluded.
Results: Out of 24,003 abstracts screened, 137 manuscripts were eligible for analysis. Fourteen countries (Australia/New Zealand, Austria, Brazil, Denmark, Finland, Japan, India, the Netherlands, Norway, Spain, South Korea, Sweden, Switzerland, UK) and USA (with a pediatric ICU database) have established ICU registries across various critical care subspecialties. Australia/New Zealand, Austria, the Netherlands, Norway, and the UK have mature registries in place, set up over two decades ago. These ICU registries are commonly maintained with a combination of data entry from data scientists, and extraction/transfer from national patient registries and electronic healthcare systems. Commonly recorded variables include basic demographic and clinical characteristics; comorbidities; common laboratories; admission diagnoses and complications; illness severity scores; treatments administered; and clinically relevant outcomes. Analyses of these registries have helped predict trends in critical care needs, and informed dozens of research projects.
Conclusion: With insights and experience gained from other mature nationwide ICU registries, a similar program can be established in the US, aimed at assessing needs, benchmarking and improving critical care delivery, and assisting critical care research.