A COMPARISON OF INTENSIVE CARE IN THE U.S.A. AND FRANCE

Abstract

1260 emergency admissions to the intensive-care units (ICUs) of five U.S.A. and seven French tertiary-care hospitals were surveyed by means of a standard severity-of-illness classification system. The 586 patients admitted to French ICUs were significantly younger than the 674 U.S.A. patients, more had been transferred from another hospital, and they remained in the ICU twice as long. Although actual death rates, severity of illness, and the amount of treatment were extremely similar, fewer French than U.S.A. patients were admitted for observation and monitoring. Invasive monitoring was used less in French patients than in U.S.A. patients. The mortality predicted for French patients if they had been treated in the U.S.A. was similar to the observed mortality in the three most frequent indications for ICU admission (cardiovascular, respiratory, and neurological organ-system failure) but was lower than the observed death rate for French gastrointestinal patients. These results suggest that future international studies within separate diagnostic groups would provide insights into the value of many services now commonly used in the treatment of acutely ill patients.