medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2004, Number 3

<< Back Next >>

Acta Med 2004; 2 (3)

Five years experience of the Intensive Care Unit of Hospital Angeles de las Lomas

Sánchez VLD

Language: Spanish
References: 38
Page: 151-157
PDF size: 67.49 Kb.


ABSTRACT

Purpose: To describe the experience in five years of the intensive care unit of Hospital Angeles de las Lomas. Material and methods: Observational, descriptive, longitudinal, prospective study during five years in the intensive care unit of a private general hospital. Variables were demographics, clinics, of laboratory, and use of resources. Statistical analysis was performed with descriptive statistics. Results: During the period there were 946 patients, 63.5% of them were males. Mean age was 58.4 ± 17.3 years (14-96 years). Most of patients came from operation room 358 (37.8%), emergency room 167 (17.7%), coronary intervention unit 162 (17.1%), and intermediate care unit 129 (13.6%). Mean APACHE II was 12.8 ± 7.1 points (0-45 points). Mean ICU stay was 4.7 ± 5.4 days (1-62 days). Mortality rate was 12.4%. Standarized mortality rate was 0.74. Resources more employed were: Antibiotics 656 (69.3%), vasopressors 525 (55.5%), mechanical ventilation 399 (42.2%), and red blood packets 318 (33.6%). Devices more used were: Urinary catheter 664 (70.2%), central venous catheter 555 (58.7%), endotracheal catheter 390 (41.2%), and pulmonary artery catheter 147 (15.5%). Conclusions: We describe the experience of one of the intensive care units of Angeles Hospital Group. Medical care and outcomes in this unit are similar to those of developed countries.


REFERENCES

  1. Halpern NA, Bettes L, Greenstein R. Federal and nationwide intensive care unit and healthcare costs: 1986-1992. Crit Care Med 1994; 22: 2001-2007.

  2. Chalfin DB, Cohen IL, Lambrinos J. The economics and cost effectiveness of critical care medicine. Intensive Care Med 1995; 21: 952-961.

  3. Donowitz LG, Wenzel RP, Hoyt JW. High risk of hospital-acquired infection in the ICU patient. Crit Care Med 1982; 10: 355-357.

  4. Wenzel RP, Thompson RL, Landry SM, Russell BS, Miller PJ, Ponce de Leon S et al. Hospital-acquired infections in intensive care unit patients: an overview with emphasis on epidemics. Infect Control Hosp Epidemiol 1983; 4: 371-375.

  5. Snider GL. Allocation of intensive care. Am J Respir Crit Care Med 1994; 150: 575.

  6. Ayres SM. New study prepares Society of Critical Care Medicine to face health care reform. Health Care Reform 1993; 21: 175.

  7. Jaffin JH, Champion HR, Boulanger BR. Economic considerations. Crit Care Clin 1993; 9: 75.

  8. Jacobs P, Noseworthy TW. National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 1990; 18: 1282.

  9. Dragstad L, Qvist J. Epidemiology of intensive care. Int J Tech Assess Health Care 1992; 8: 395.

  10. Singer M, Myers S, Hall G et al. The cost of intensive care: A comparison on one unit between 1988 and 1991. Int Care Med 1994; 20: 542.

  11. Oye RK, Bellamy PE. Patterns of resource consumption in medical intensive care. Chest 1991; 99: 685.

  12. The Quality Indicator Study Group. An approach to the evaluation of quality indicators of the outcome of care in hospitalized patients, with a focus on nosocomial infection indicators. Infect Control Hosp Epidemiol 1995; 16: 308-316.

  13. McLaughlin CP, Kaluzny AD. Total quality management in health: Making it work. Health Care Manage Rev 1990; 15: 7.

  14. Milakovich ME. Creating a total quality health care environment. Health Care Manage Rev 1991; 6: 9.

  15. Buccini EP. Total quality management in the critical care environment. Crit Care Unit Manage 1993; 9: 455.

  16. Paz HL, Livingston J. Using a benchmarking system to improve patient care and assist in technology assessment. Physician Executive 1996; 22: 10.

  17. Garland A, Paz HL. Improving quality of care in the ICU. In: Hall JB, Schmidt GA, Wood LDH (eds.). 2nd ed. McGraw Hill. 1998: 25-34.

  18. Knaus WA, Zimmerman JE, Wagner DP et al. APACHE - Acute Physiology and Chronic Health Evaluation: A physiologically based classification system. Crit Care Med 1981; 9: 191-197.

  19. Knaus WA, Draper EA, Wagner DP et al. APACHE II: A severity of disease classification. Crit Care Med 1985; 13: 818-829.

  20. Knaus WA, Wagner DP, Draper EA et al. The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Crit Care Med Chest 1991; 100: 619.

  21. Le Gall JR, Loirat P, Alperovich A et al. A Simplified Acute Physiology Score for ICU patients. Crit Care Med 1984; 12: 975-977.

  22. Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993; 270: 2957.

  23. Lemeshow S, Teres D, Pastides H et al. A method for predicting survival and mortality of ICU patients using objectively derived weigths. Crit Care Med 1985; 13: 519.

  24. Lemeshow S, Teres D, Klar J et al. Mortality probability models (MPM II) based on an international cohort of intensive care unit patients. JAMA 1993; 270: 2478.

  25. Osler TM, Rogers FB, Glance LG et al. Predicting survival, length of stay, and cost in the surgical intensive care unit: APACHE II versus ICISS. J Trauma 1998; 45: 234-237.

  26. Charlson ME, Pompei P, Ales KL et al. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chron Dis 1987; 40: 373-383.

  27. Miranda RD, Moreno R, Iapichino G. Nine equivalents of nursing manpower use score (NEMS). Intensive Care Med 1997; 23: 760-765.

  28. Donchin Y, Gopher D, Olin M et al. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med 1995; 23: 294-300.

  29. Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr. Caring for the critically ill patient: current and projected workforce requirements for care of the critically ill and patients with pulmonary disease – can we meet the requirements of anaging population? JAMA 2000; 284: 2762-2770.

  30. Halpern NA, Bettes L, Greenstein R. Federal and nationwide intensive care units and healthcare costs: 1986-1992. Crit Care Med 1994; 22: 2001-2007.

  31. Sánchez-Velázquez LD, Reyes SME, García JME, Manterola CSO, DÉctor LDM. Correlation between two therapeutic intervention scoring methods and hospital costs. A Mexican study. Crit Care Med 2001; 29(Suppl): A181.

  32. Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH et al. The prevalence of nosocomial infection in intensive care units in Europe. JAMA 1995; 274: 639-644.

  33. Ponce de León-Rosales S, Molinar-Ramos F, Domínguez-Cherit G, Rangel-Frausto MS, Vázquez-Ramos VG. Prevalence of infections in intensive care units in Mexico: A multicenter study. Crit Care Med 2000; 28: 1316-1321.

  34. Glance LG, Osler TM, Dick A. Rating the quality of intensive care units: Is it a function of the intensive care unit scoring system? Crit Care Med 2002; 30: 1976-1982.

  35. Render ML, Kim M, Welsh DE, Timmons S, Johnston J, Hui S et al. Automated intensive care unit risk adjustment: Results from a National Veterans Affairs study. Crit Care Med 2003; 31: 1638-1646.

  36. Valentin A, Jordan B, Lang T, Hiesmayr M, Metnitz PGH. Gender-related differences in intensive care: A multiple-center cohort study of therapeutic interventions and outcome in critically ill patients. Crit Care Med 2003; 31: 1901-1907.

  37. Rosenberg AL, Watts Ch. Patients readmitted to ICUs. A systematic review of risk factors and outcomes. Chest 2000; 118: 492-502.

  38. Moreno R, Miranda DR. Nursing staff in intensive care in Europe: The mismatch between planning and practice. Chest 1998; 113: 752-758.




2020     |     www.medigraphic.com