Replicating Cardiac Intensive Care Units: The Importance of Structure, Process, and Outcomes

Over recent years, cardiac intensive care units (CICUs) have been established with the aim of providing improved care for patients after surgery.1 From a recent sample of 20 922 patients in the Society of Thoracic Surgeons Congenital Heart Surgery Database, Burstein et al2 explored whether postoperative patients admitted to a CICU have better outcomes than those admitted to other ICUs as measured by using risk-adjusted mortality rates. The results of their sophisticated analysis revealed that, with the exception of 1 subgroup, there were no significant differences in outcomes from postoperative admissions to CICUs and other ICUs. The results indicate that the widespread establishment of CICUs may not independently guarantee substantial improvement in outcomes.