• Stefano Finazzi, Giulia Paci, Luca Antiga, Obou Brissy, Greta Carrara, Daniele Crespi, Gabor Csato, Akos Csomos, Or Duek, Sara Facchinetti, Joanne Fleming, Elena Garbero, Massimo Gianni, Primoz Gradisek, Rafael Kaps, Theodoros Kyprianou, Isaac Lazar, Malgorzata Mikaszewska-Sokolewicz, Matteo Mondini, Giovanni Nattino, Carlo Olivieri, Daniele Poole, Claudio Previtali, Danilo Radrizzani, Carlotta Rossi, Stefano Skurzak, Mario Tavola, Nektaria Xirouchaki, Guido Bertolini, and GiViTI-PROSAFE collaboration.
• GiViTI Coordinating Center, Institute for Pharmacological Research Mario Negri IRCCS, Clinical Research Center for Rare Diseases Aldo and Cele Daccò, Ranica, Bergamo, Italy.
• Minerva Anestesiol. 2020 Dec 1; 86 (12): 1305-1320.

BackgroundLong-lasting shared research databases are an important source of epidemiological information and can promote comparison between different healthcare services. Here we present PROSAFE, an advanced international research network in intensive care medicine, with the focus on assessing and improving the quality of care. The project involved 343 ICUs in seven countries. All patients admitted to the ICU were eligible for data collection.MethodsThe PROSAFE network collected data using the same electronic case report form translated into the corresponding languages. A complex, multidimensional validation system was implemented to ensure maximum data quality. Individual and aggregate reports by country, region, and ICU type were prepared annually. A web-based data-sharing system allowed participants to autonomously perform different analyses on both own data and the entire database.ResultsThe final analysis was restricted to 262 general ICUs and 432,223 adult patients, mostly admitted to Italian units, where a research network had been active since 1991. Organization of critical care medicine in the seven countries was relatively similar, in terms of staffing, case mix and procedures, suggesting a common understanding of the role of critical care medicine. Conversely, ICU equipment differed, and patient outcomes showed wide variations among countries.ConclusionsPROSAFE is a permanent, stable, open access, multilingual database for clinical benchmarking, ICU self-evaluation and research within and across countries, which offers a unique opportunity to improve the quality of critical care. Its entry into routine clinical practice on a voluntary basis is testimony to the success and viability of the endeavor.

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