Comparison of Incident Rates Intensive and Non-Intensive Care Hbo One Month Observational Study (original) (raw)
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1994
Inlroduction;; Mortality prediction in critically ill patients is an every day routine in ICUs. Our aim is to evaluate prognostic accuracy of SAPS II as compared with the predictive capabilities of its predecesor SAPS 1, and with the one of APACHE II, probably the most used prognostic method of the available ones. Patients and S~tting; 568 patients admitted in two medical-surgical ICUs of two Hospitals (III-A-and II-B-level) were consecutively admitted (A: 358 and B: 210 patients) and prospectively admitted in the study. Methodology: All patients outcome were predicted by SAPS I and SAPS, as well as APACHE II, using the worst values availables during the first 24 h of stay in ICU. For APACHE II diagnostic grouping according original description was also considered. In all cases, procedence, type of patient (surgical or not, emergency admission or not), sex, age, length of stay (LOS) and other epidemiological data were also collected. Mortality was considered at the end of the hospitalary stay. Non paired Student T test, Chi square test, and Regression methods were used in tha analysis. Overall performance of prognostic methods were compared by means of the calculation of the areas under ROC curves. Significative differences were associated to p < 0.05. Results; Mortality in the study was 21% (p NS A vs B) and there were not significant differences in LOS. SAPS I and SAPS II revealed significant differences in severity when studying A and B populations (p < 0.014 and p < 10 .4) and risk of death evaluation was greater in B population when using SAPS II. For the whole sample and at probability level of 50 %, accuracy of prediction was 83 % for SAPS I and 80 % for SAPS II. At probability level of 90 %, accuracies of prediction for both methods were respectively 79 % and 82 %.. When using APACHE II, accuracies were 82% and 80 %. There were not signinficant differences, at any of the considered probability levels (50, 70 and 90 %), between real mortality and predicted mortality when any of the three methodologies were utilized, Facing the evidence that SAPS II do not represent, in our population, predictive advantages in front of SAPS I, a regression equation has been developed between SAPS II and SAP I (
Anaesthesiology Intensive Therapy
The aim of this study was to evaluate possible differences in the functioning of two selected intensive care units in Poland and Finland. The activity of the units was analysed over a period of one year. The following parameters were compared: demography of treated populations, site of admission, category of illness, severity of illness (APACHE-II scale), mean length of stay, demanded workload (TISS-28 scale), mortality (both ICU and hospital) and standardized mortality ratio (SMR). The results of this study indicated that most of the patients in the Polish ICU, regardless of age, diagnosis and APACHE II score, presented significantly longer lengths of stay (14.65 ± 13.6 vs 4.1 ± 4.7 days, P = 0.0001), higher mean TISS-28 score (38.9 ± 9.1 vs 31.2 ± 6.1, P = 0.0001) and higher ICU and hospital mortality (41.5% vs 10.2% and 44.7% vs 21.8%, respectively, P = 0.0001). The values of SMR were 0.9 and 0.85 for the Finnish and Polish ICUs, respectively. The collected data indicate huge dif...
Bezmialem science, 2017
Objective: To evaluate demographic data of patients hospitalized in the intensive care unit (ICU) of a tertiary health institution and to reveal demographic and laboratory parameters associated with mortality. Methods: Between January 2008 and 2013, patients who were hospitalized in our clinic were retrospectively analyzed. During the evaluation, the demographic characteristics of patients; creatinine, urea, uric acid, albumin, LDH, ALT, AST, sodium, and hemoglobin levels; hematocrit; and white blood cell and platelet counts were assessed. The patients were then divided into two groups according to those who died and those transferred to a service. Results: Between January 2008 and 2013, a total of 3945 patients were enrolled. In patients who died in the ICU, the average age, presence of an operation history, and hospitalization time in the ICU were statistically significant. After the evaluation, laboratory parameters including urea, creatinine, uric acid, and LDH levels and white blood cell count were significantly higher in patients who died in the ICU than in those who were transferred to a relevant service as healthy patients. Further, serum albumin, and hemoglobin levels; hematocrit; and platelet count were significantly lower in patients who died. Conclusion: In elderly patients, the presence of am operation history and elevated urea, creatinine, uric acid, and LDH levels and white blood cell counts and decreased albumin and hemoglobin levels; platelet counts; and hematocrit were significantly associated with higher mortality rates in the ICU.
Intensive Care Medicine, 2005
Prolonged Stay in the Intensive Care Unit: A Retrospective Analysis of Six Years
Namık Kemal Tıp Dergisi
Amaç: Yoğun bakım ünitesinde (YBÜ) uzamış yatış birçok faktörle ilişkilidir ve çeşitli sorunlara neden olur. Bu çalışma, 30 günden fazla YBÜ'de tedavi gören hastaların klinik özelliklerini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Yüz yetmiş sekiz hastanın verileri retrospektif olarak incelendi. YBÜ'de 7-30 gün yatış süresi olanlar "YBÜ yatış günü <30 gün-Grup 1", 30 gün ve üzeri yatış süresi olanlar ise "YBÜ yatış günü ≥30 gün-Grup 2" olarak tanımlandı. Bu çalışmada YBÜ'de yatış süresinin uzamasına neden olan faktörler araştırıldı. Hastane veri sisteminden elde edilen veriler karşılaştırıldı. Bulgular: Yüz yetmiş sekiz hastanın yaş ve cinsiyet dağılımları iki grup arasında istatistiksel olarak farklı değildi (sırasıyla; p=0,355 ve p=0,758). YBÜ'de ≥30 gün kalan grupta trakeostomi oranı <30 gün YBÜ'de kalan gruba göre anlamlı olarak daha yüksekti (p<0,05). Bu çalışmada 30 gün ve üzeri YBÜ'de kalan hastalarda 30 günden az kalanlara göre daha sık perkütan endoskopik gastrostomi işlemi uygulandı (p=0,000). Sonuç: Uzun süreli yoğun bakım yatışlarına birden fazla faktör neden olmaktadır. Yoğun bakım yataklarından en iyi şekilde yararlanmak ve mortalite artışına ve olumsuz finansal sonuçlara neden olan uzun süreli yoğun bakım yatışlarını önlemek için palyatif bakım üniteleri ve evde bakım tesislerinin sık kullanılması gerekmektedir.
Death and dying in the intensive care unit
2015
In the Netherlands most patients die in the intensive care unit (ICU) after a decision to withdraw life-sustaining measures (WOLSM) has been made. The ICU patients in whom life-sustaining measures are withdrawn are relatively old and are severely ill, according to the APACHE and SOFA scores. The patient group with severe trauma to the central nervous system has the highest incidence of WOLSM. Although this seems logical, just because neurological outcome is so difficult to predict, early withdrawing introduces a substantial self-fulfilling prophecy, making reliable prognostication in the near future almost impossible. Especially in the young patient group, even in the case of severe neurological damage, patience is to be advised.