• K M Rowan, J H Kerr, E Major, K McPherson, A Short, and M P Vessey.
• Department of Public Health and Primary Care, University of Oxford, Radcliffe Infirmary.
• BMJ. 1993 Oct 16;307(6910):972-7.

ObjectivesTo describe the extent of variation in the case mix of adult admissions to general intensive care units in Britain and Ireland and investigate the impact of such variation on outcome.DesignProspective, cohort study of consecutive admissions to intensive care units.Setting26 general intensive care units in Britain and Ireland.Subjects9099 admissions to the intensive care units studied.Main Outcome MeasureDeath or survival at discharge before and after adjustment of case mix (age, history of chronic conditions, surgical status, diagnosis, and severity of illness) according to the APACHE II method.ResultsImportant differences in case mix were found, with large variations between the units. Hospital mortality was significantly associated with most of the case mix factors investigated.ConclusionsComparing crude death rates in hospital between intensive care units may be misleading indicators of performance. The collection of data on case mix needs to be standardised and differences in case mix adjusted for when comparing outcome between different intensive care units.

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