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Table 3 Primary and secondary outcomes

From: Computerized physician order entry of a sedation protocol is not associated with improved sedation practice or outcomes in critically ill patients

Variable

No protocol

CPOE protocol

Revised CPOE protocol

P-value

P-value

P-value

(Mean ± SD)

(n = 91)

(n = 97)

(n = 91)

1 vs. 2

2 vs. 3

1 vs. 3

Primary outcomes

 Mechanical ventilation duration, mean ± SD, days

10 ± 9

12 ± 11

10 ± 8

0.21

0.2

0.98

 ICU LOS, mean ± SD, days

12 ± 10

13 ± 12

13 ± 11

0.78

0.91

0.69

 Hospital LOS, mean ± SD, days

63 ± 85

40 ± 37

46 ± 42

0.02

0.32

0.09

 ICU mortality, n (%)

24 (26)

38 (39)

16 (18)

0.06

0.001

0.15

 Hospital mortality, n (%)

36 (40)

43 (44)

29 (32)

0.51

0.08

0.28

Secondary outcomes

Average daily doses of analgesics and sedatives

 Fentanyl, mcg/day

2647 ± 2212

3720 ± 3286

2208 ± 2115

0.009

0.0002

0.17

 Morphine, mg/day

0.71 ± 4.88

0.36 ± 2.11

0.45 ± 2.18

0.54

0.79

0.64

 Dexmedetomidine, mcg/day

47.6 ± 113.7

48.3 ± 153.5

40.6 ± 124.1

0.97

0.71

0.69

 Midazolam, mg/day

84 ± 107

78 ± 101

68 ± 96

0.71

0.48

0.3

 Propofol, mg/day

271 ± 650

274 ± 833

509 ± 961

0.97

0.07

0.052

 Lorazepam, mg/day

0.09 ± 0.32

0.06 ± 0.26

0 ± 0

0.47

0.04

0.01

 Haloperidol, mg/day

0.27 ± 0.87

0.42 ± 1.77

0.23 ± 0.85

0.45

0.34

0.72

 Paralytics, mg/day

28 ± 61

20 ± 60

21 ± 49

0.34

0.84

0.41

Average NRS, SAS and GCS scores

 NRS score, mean ± SD

0.24 ± 0.5

0.16 ± 0.36

1.02 ± 0.73

0.20

<0.0001

<0.0001

 SAS score, mean ± SD

2.5 ± 1.1

2.3 ± 1.1

2.5 ± 1.2

0.47

0.25

0.66

 GCS score, mean ± SD

6.8 ± 3.2

6.6 ± 3.2

6.9 ± 2.9

0.84

0.36

0.47

Sedation-related complications during ICU stay

 Agitated (SAS = 5), n (%)

37 (40.7)

29 (29.9)

3 (3.3)

0.12

<0.0001

<0.0001

 Very agitated (SAS = 6), n (%)

10 (11)

6 (6.2)

3 (3.3)

0.24

0.5

0.04

 Dangerous agitation (SAS = 7), n (%)

4 (4.4)

1 (1)

2 (2.2)

0.2

0.61

0.68

 NGT self-removal, n (%)

2 (2.2)

2 (2.1)

0 (0)

1

0.5

0.5

 ETT self-removal, n (%)

2 (2.2)

0 (0)

0 (0)

0.23

-

0.5

 Brain CT scans for mental status assessment, n (%)

1 (1.1)

0 (0)

0 (0)

0.48

-

1

  1. 1: No protocol; 2: CPOE Protocol; 3: Revised CPOE Protocol; CT computed tomography, ETT endotracheal tube, GCS Glasgow Coma Scale, ICU intensive care unit, LOS length of stay, NGT nasogastric tube, NRS Numeric Rating Scale, SAS Sedation-Agitation Scale, SD standard deviation