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Alfred F. Connors, Jr, MD; Theodore Speroff, PhD; Neal V. Dawson, MD; Charles Thomas; Frank E. Harrell, Jr, PhD; Douglas Wagner, PhD; Norman Desbiens, MD; Lee Goldman, MD, MPH; Albert W. Wu, MD; Robert M. Califf, MD; William J. Fulkerson, Jr, MD; Humberto Vidaillet, MD; Steven Broste, MS; Paul Bellamy, MD; Joanne Lynn, MD; William A. Knaus, MD

JAMA. 1996;276(11):889-897.

Abstract
Objective.
—To examine the association between the use of right heart catheterization (RHC) during the first 24 hours of care in the intensive care unit (ICU) and subsequent survival, length of stay, intensity of care, and cost of care.

Design.
—Prospective cohort study.

Setting.
—Five US teaching hospitals between 1989 and 1994.

Subjects.
—A total of 5735 critically ill adult patients receiving care in an ICU for 1 of 9 prespecified disease categories.

Main Outcome Measures.
—Survival time, cost of care, intensity of care, and length of stay in the ICU and hospital, determined from the clinical record and from the National Death Index. A propensity score for RHC was constructed using multivariable logistic regression. Case-matching and multivariable regression modeling techniques were used to estimate the association of RHC with specific outcomes after adjusting for treatment selection using the propensity score. Sensitivity analysis was used to estimate the potential effect of an unidentified or missing covariate on the results.

Results.
—By case-matching analysis, patients with RHC had an increased 30-day mortality (odds ratio, 1.24; 95% confidence interval, 1.03-1.49). The mean cost (25th, 50th, 75th percentiles) per hospital stay was $49300 ($17000, $30500, $56600) with RHC and $35700 ($11 300, $20600, $39200) without RHC. Mean length of stay in the ICU was 14.8 (5,9, 17) days with RHC and 13.0 (4,7, 14) days without RHC. These findings were all confirmed by multivariable modeling techniques. Subgroup analysis did not reveal any patient group or site for which RHC was associated with improved outcomes. Patients with higher baseline probability of surviving 2 months had the highest relative risk of death following RHC. Sensitivity analysis suggested that a missing covariate would have to increase the risk of death 6-fold and the risk of RHC 6-fold for a true beneficial effect of RHC to be misrepresented as harmful.

Conclusion.
—In this observational study of critically ill patients, after adjustment for treatment selection bias, RHC was associated with increased mortality and increased utilization of resources. The cause of this apparent lack of benefit is unclear. The results of this analysis should be confirmed in other observational studies. These findings justify reconsideration of a randomized controlled trial of RHC and may guide patient selection for such a study.

Author Affiliations
for the SUPPORT Investigators

From the Departments of Medicine and Epidemiology and Biostatistics, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio (Drs Connors, Speroff, and Dawson and Mr Thomas); Duke University Medical Center, Durham, NC (Drs Harrell, Califf, and Fulkerson); University of Virginia, Charlottesville (Drs Wagner and Knaus); the Marshfield (Wis) Medical Research Foundation, Marshfield Clinic (Drs Desbiens and Vidaillet and Mr Broste); Beth Israel Hospital, Boston, Mass (Dr Goldman); Johns Hopkins Medical Center, Baltimore, Md (Dr Wu); the UCLA Medical Center, Los Angeles, Calif (Dr Bellamy); and Center to Improve Care of the Dying, George Washington University, Washington, DC (Dr Lynn). Drs Connors and Harrell are now with the University of Virginia

Footnotes
School of Medicine, Charlottesville, and Dr Speroff is now with the Magic Valley Medical Center, Twin Falls, Idaho.

A complete list of the SUPPORT Investigators appears in JAMA. 1995;274:1591-1598; correction JAMA. 1996; 275:1232.

The opinions and findings contained in this article are those of the authors and do not necessarily represent the views of the Robert Wood Johnson Foundation or its Board of Trustees.

Reprints: Alfred F. Connors, Jr, MD, Division of Health Services and Outcomes Research, Department of Health Evaluation Sciences, University of Virginia School of Medicine, Health Sciences Center, Box 600, Charlottesville, VA 22908.

Concepts in Emergency and Critical Care section editor: Roger C. Bone, MD, Consulting Editor, JAMA.

Advisory Panel: Bart Chernow, MD, Baltimore, Md; David Dantzker, MD, New Hyde Park, NY; Jerrold Leiken, MD, Chicago, Ill; Joseph E. Parrillo, MD, Chicago, Ill; William J. Sibbald, MD, London, Ontario; and Jean-Louis Vincent, MD, PhD, Brussels, Belgium.

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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FULL TEXT  

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FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT  

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FULL TEXT  

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ABSTRACT | FULL TEXT  

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ABSTRACT | FULL TEXT  

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FULL TEXT  

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FULL TEXT  

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Kessler et al.
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ABSTRACT | FULL TEXT  

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Vieillard-Baron et al.
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FULL TEXT  

Early Use of the Pulmonary Artery Catheter and Outcomes in Patients With Shock and Acute Respiratory Distress Syndrome: A Randomized Controlled Trial
Richard et al.
JAMA 2003;290:2713-2720.
ABSTRACT | FULL TEXT