Critical care primary services are associated with reduced midazolam use in the intensive care unit

Table 1 Demographics by critical care primary, n (%)

	Intensivist staffing model
	No	Yes
Number patients	376.0	3429.0
Number of males	209.0	2156.0
Percent males	55.6	62.9
Mean age (years)	68.1	65.8
Age (SD, deviation)	13.9	12.9
Mean weight (kg)	90.5	88.8
Weight (SD, deviation)	27.3	24.1
Charlson comorbidity index (mean ± SD)	6.0	5.6
Charlson comorbidity index (SD, deviation)	2.8	2.8
Sofa score (mean ± SD)	7.9	6.8
Sofa score (SD, deviation)	2.5	2.6
Hospital mortality	26.1	13.2
Hospital diagnoses
Acute respiratory failure	217 (58)	883 (26)
Sepsis	194 (52)	660 (19)
Septic shock	137 (36)	471 (14)
Pneumonia	130 (35)	549 (16)
Cardiac arrest	44 (12)	322 (9)
Unspecified shock	42 (11)	214 (6)
COVID-19 pneumonia	40 (11)	130 (4)
Viral pneumonia	38 (10)	109 (3)
Alcohol withdrawal	35 (9)	136 (4)
Cardiogenic shock	22 (6)	233 (7)
Hypovolemic shock	21 (6)	70 (2)
ARDS	18 (5)	110 (3)
Seizure	18 (5)	88 (3)
Status epilepticus	2 (1)	47 (1)

COVID-19: Coronavirus disease 2019; ARDS: Acute respiratory distress syndrome.

Table 2 Discharged deceased and midazolam use, n (%)

	Midazolam use1,a
Deceased	No	Yes
No	3020 (93)	236 (7)
Yes	432 (79)	117 (21)

¹χ² = 108.73.

^aP < 0.001.

Table 3 Critical care medicine primary and midazolam use

	Midazolam use1,a
Intensivist staffing model	No	Yes
No	210 (56)	166 (44)
Yes	3242 (95)	187 (5)

¹χ² = 598.23.

^aP < 0.001.

Table 4 Teaching intensive care unit and midazolam use

	Midazolam use1,a
Teaching intensive care unit	No	Yes
No	614 (73)	225 (27)
Yes	2838 (96)	128 (4)

¹χ² = 390.78.

^aP < 0.001.

Table 5 Multivariate analysis on demographics and risk factors associated with the use of continuous midazolam infusion

Predictors	OR	95%CI (lower limit, upper limit)	P value
Age > 65 years	0.43	0.31, 0.59	< 0.0001
Teaching ICU	0.31	0.23, 0.42	< 0.0001
CCM primary	0.11	0.08, 0.16	< 0.0001
Charlson score > 5	0.94	0.69, 1.29	0.7151
SOFA score > 7	1.74	1.30, 2.33	0.0002
Acute respiratory failure	2.11	1.51, 2.94	< 0.0001
ARDS	6.95	3.82, 12.64	< 0.0001
Cardiogenic shock	3.01	1.95, 4.64	< 0.0001
Septic shock	0.80	0.51, 1.25	0.3324
Sepsis	1.22	0.79, 1.88	0.3714
Hypovolemic shock	1.05	0.52, 2.12	0.8912
Unspecified shock	1.51	1.00, 2.28	0.0504
Cardiac arrest	1.38	0.94, 2.02	0.1034
Pneumonia (bacterial)	1.56	1.14, 2.14	0.005
Viral pneumonia	7.80	2.11, 28.80	0.0021
COVID PNA	0.41	0.11, 1.49	0.1742
Seizure	1.77	0.92, 3.42	0.0895
Status epilepticus	13.17	6.56, 26.45	< 0.0001
Alcohol withdrawal	2.30	1.41, 3.74	0.0008

OR: Odds ratios; CI: Confidence interval; ICU: Intensive care unit; CCM: Critical care medicine; SOFA: Sequential Organ Failure Assessment; ARDS: Acute respiratory distress syndrome; COVID PNA: Coronavirus disease peptide nucleic acid.