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2009, Número 4

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Med Crit 2009; 23 (4)


Primer lugar: Premio «Dr. Mario Shapiro»
Calidad de la atención médica en las Unidades de Terapia Intensiva mexicanas. Estudio multicéntrico

Sánchez VLD

Idioma: Español
Referencias bibliográficas: 93
Paginas: 187-198
Archivo PDF: 237.70 Kb.


RESUMEN

Antecedentes: Las UTI nacionales carecen de un sistema de evaluación de su desempeño. Nuestro equipo ha validado herramientas metodológicas y ahora se pretende aplicarlas de manera conjunta para crearlo.
Objetivos: Desarrollar indicadores de CAM en las UTI nacionales y proponer sus umbrales críticos.
Pacientes y métodos: Diseño: Cohorte prospectiva. Sitios: 22 UTI. Periodo: 6 años. Población: Pacientes › 15 años. Variables: Clínicas, APACHE II, escalas Bruselas y NEMS. Análisis estadístico: Estadística descriptiva y gráficos de correlación entre índices de desempeño clínico y económico.
Resultados: Ingresaron 11,681 pacientes al estudio, 52.4% hombres. La edad fue 53.1 ± 18.8 años. El APACHE II fue 14.1 ± 6.9. La RME fue 1.26. Los indicadores más notables fueron: ayuno prolongado en 33.0%, SDOM en 31.7%, estancia prolongada en 24.6%, insatisfacción familiar en 23.5% e IRA 21.5%. En las gráficas desempeño clínico-económico, las instituciones gubernamentales mostraron un uso apropiado de recursos. La unidad privada mostró una menor mortalidad con un menor uso de recursos. La mayoría (72.7%) de los centros participantes tuvieron un aceptable desempeño clínico-económico.
Conclusiones: Se describen indicadores de CAM para las UTI mexicanas y se proponen métodos para su evaluación.


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