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Background <p>Intensive care units (ICUs) account for 15 to 20% of the national healthcare expenditures in France, although representing only 2% of the annual national hospitalizations. Published data on critically ill patient characteristics and intensive care unit (ICU) organizational aspects in France are scarce but could help optimize the critical care system organization.</p> Methods <p>We performed an ancillary analysis of the GAME-OVER study, conducted from November 2022 to March 2023, over a 24-h period in each ICU, to precisely describe the ICU activity in France. Characteristics of enrolled patients and ICUs were analyzed according to the healthcare structure type and the self-reported main activity of each ICU, and were compared using univariate analysis (p &lt; 0.05 considered as significant).</p> Results <p>Data from 81 ICUs, representing 1218 beds, were analyzed. Participating ICUs were mainly mixed ICUs (56%), from teaching hospitals (54%). Among the 1048 analyzed ICU patients, sex ratio female/male was 1/3, median age was 63 [51–71] years, median sepsis organ failure assessment score was 4 [2–7], and 42% of patients had at least two organ failures. Patients were mainly admitted for medical reasons (52%), mostly represented by respiratory failure (26%). Mechanical ventilation, non-invasive ventilation, high flow oxygen therapy, renal replacement therapy and vasoactive therapy were required in 45.5%, 6.1%, 5.3%, 12% and 30.7% of patients, respectively. Median nurse-to-patient ratio was 2.4 [2.0–2.7] on day shift. Overall, 46 structures (56.8%) declared a nurse-to-patient ratio &gt; 2.5 either on day time or night time. Bed occupancy rate was 91% over the 24-h study period. However, 70 (5.7%) ICU beds were administratively closed and could not admit any patient.</p> Conclusion <p>In more than 20% of French ICUs, the bed occupancy rate is nearly 91%, despite 5.7% of beds being unavailable, and the nurse-to-patient ratio exceeding recommended levels.</p> Trial registration <p>The full study protocol was registered in clinicaltrials.gov (NCT05553054).</p>

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Characteristics of French intensive care units and patients: an ancillary analysis of the GAME-OVER study

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  • 发表日期：

    2025年12月5日

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  • Enora Atchade,
  • Pierre-Julien Cungi,
  • Stéphanie Pons,
  • Claire Dahyot-Fizelier,
  • Magali Cesana,
  • Anne Claire Lukaszewicz,
  • Belaid Bouhemad,
  • Pierre Trouiller,
  • Jonathan Chelly,
  • Philippe Montravers,
  • Fanny Vardon,
  • Erwan D’Aranda,
  • Emmanuel Besnier,
  • Léa Satre Buisson,
  • Nicolas Montgardon,
  • Philippe Aries,
  • Roland Amathieu,
  • Yoann Launey,
  • Benjamin Chousterman,
  • Jordi Miatello,
  • Olivier Collange,
  • Belaïd Bouhemad,
  • Bernard Allaouchiche,
  • Mathieu Desmard,
  • Ines Lakbar,
  • Céline Guichon,
  • Jérome Morel,
  • Chloé Allary,
  • Laure Bonnet,
  • Marie Bruyere,
  • Stéphanie Deryckere,
  • Agnès Gendre,
  • Marion Griton,
  • Stéphane Fournier,
  • Mehdi Hafiani,
  • Florence Lallemant,
  • Charlotte Martin,
  • Jean-Claude Pauchard,
  • Mathieu Schoeffler,
  • Clémentine Taconet,
  • Laurent Zieleskiewicz,
  • Hélène Beloeil,
  • Marwan Bouras,
  • Raphaël Cinotti,
  • François Depret,
  • Alexandre Godon,
  • Alice Jacquens,
  • Sébastien Kerever,
  • Élodie Lang,
  • Maxime Léger,
  • Aurélien Mazeraud,
  • Ludovic Muret,
  • Vincent Pey,
  • Céline Monard,
  • Amélie Rolle,
  • Stéphanie Sigaut,
  • Laure Bonnet,
  • Fanny Giannoni,
  • Olivier Collange,
  • Mathieu Schoeffler,
  • Nicolas Mayeur,
  • Pierre-Louis Querer,
  • Toufik Kamel,
  • Paër-Sélim Abback,
  • Pierre Albaladejo,
  • Adrien Auvet,
  • Julio Badie,
  • Fernando Daniel Berdaguer Ferrari,
  • Fanny Berenguer,
  • Fanny Bernard,
  • Rémy Bernard,
  • Rudy Berthezene,
  • Anne Bignon,
  • Pauline Bleuze,
  • Laure Bonnet,
  • Yvonnick Boue,
  • Boris Boulanger,
  • Guillaume Boulay,
  • Marie Boulo,
  • Fanny Bounes,
  • Pierre Bouzat,
  • Jean-François Carabalona,
  • Dimitri Ceausu,
  • Claire Chabre,
  • Véronique Chaillet,
  • David Charriere,
  • Riad Chelha,
  • Noémie Clavieras,
  • Marion Costecalde,
  • Pierre Couhault,
  • Jullien Crozon-Clauzel,
  • Sophie Debord-Peguet,
  • Hugues De Courson,
  • Mathilde Delage,
  • Agathe Delbove,
  • Olivier Desebbe,
  • Olivier Duranteau,
  • Sébastien Ehrminger,
  • Djilali Elaroussi,
  • Vedat Eljezi,
  • Brice Fermier,
  • Camille Foucault,
  • Sylvain Garnier,
  • Camille Gaydon-Serres,
  • Cyrille Geay,
  • Marie Geslain,
  • Fanny Giannoni,
  • Clarisse Gierczak,
  • Emmanuelle Guigal,
  • Mathieu Guilbart,
  • Jérémie Guillemin,
  • Emmanuelle Hammad,
  • Clément Hoffmann,
  • Edith Hourcastagnou,
  • Emmanuelle Jaillette,
  • Marie Jan,
  • Toufik Kamel,
  • Agathe Kudela,
  • Francoise Labat,
  • Marc Laffon,
  • Thomas Lancry,
  • Sigismond Lasocki,
  • Yoann Launey,
  • Grégoire Le Gac,
  • Vincent Legros,
  • Yann Le Guen,
  • Quentin Levrat,
  • Amaury Lhermitte,
  • Clément Magand,
  • Stéphanie Malaquin,
  • Charlotte Martin,
  • Olivier Martin,
  • Gabriel Masson,
  • Yannick Masson,
  • Nicolas Mayeur,
  • Anthony Merlin,
  • Abolfazl Mohebbi-Amoli,
  • Martin Mombrun,
  • Jean-François Parizano,
  • Cyril Pernod,
  • Fanny Planquart,
  • Gaëtan Plantefeve,
  • Quentin Ressaire,
  • Faustine Reynaud,
  • Clothilde Schilte,
  • Mathieu Schoeffler,
  • Johan Schmitt,
  • Géraldine Selly,
  • Arnaud Sement,
  • Benjamin Soyer,
  • Emanuele Turbil,
  • Jean Turc,
  • David Vandroux,
  • Antoine Villecheze,
  • Hadrien Winiszewski,
  • Baptiste Balanca

摘要

Background

Intensive care units (ICUs) account for 15 to 20% of the national healthcare expenditures in France, although representing only 2% of the annual national hospitalizations. Published data on critically ill patient characteristics and intensive care unit (ICU) organizational aspects in France are scarce but could help optimize the critical care system organization.

Methods

We performed an ancillary analysis of the GAME-OVER study, conducted from November 2022 to March 2023, over a 24-h period in each ICU, to precisely describe the ICU activity in France. Characteristics of enrolled patients and ICUs were analyzed according to the healthcare structure type and the self-reported main activity of each ICU, and were compared using univariate analysis (p < 0.05 considered as significant).

Results

Data from 81 ICUs, representing 1218 beds, were analyzed. Participating ICUs were mainly mixed ICUs (56%), from teaching hospitals (54%). Among the 1048 analyzed ICU patients, sex ratio female/male was 1/3, median age was 63 [51–71] years, median sepsis organ failure assessment score was 4 [2–7], and 42% of patients had at least two organ failures. Patients were mainly admitted for medical reasons (52%), mostly represented by respiratory failure (26%). Mechanical ventilation, non-invasive ventilation, high flow oxygen therapy, renal replacement therapy and vasoactive therapy were required in 45.5%, 6.1%, 5.3%, 12% and 30.7% of patients, respectively. Median nurse-to-patient ratio was 2.4 [2.0–2.7] on day shift. Overall, 46 structures (56.8%) declared a nurse-to-patient ratio > 2.5 either on day time or night time. Bed occupancy rate was 91% over the 24-h study period. However, 70 (5.7%) ICU beds were administratively closed and could not admit any patient.

Conclusion

In more than 20% of French ICUs, the bed occupancy rate is nearly 91%, despite 5.7% of beds being unavailable, and the nurse-to-patient ratio exceeding recommended levels.

Trial registration

The full study protocol was registered in clinicaltrials.gov (NCT05553054).