Demographic and clinical variation of adult intensive care unit utilization from a geographically defined population

Seferian, Edward G.; Afessa, Bekele

doi:10.1097/01.ccm.0000227652.08185.a4

Cited by 36 publications

(35 citation statements)

References 44 publications

(38 reference statements)

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“…4 Our findings correlates with the findings that with increasing age ICU admission and utilization rates are proportionately increased in the recent years. 10,11 ICU admission also increased significantly with an increasing number of co morbid conditions among which Cardiovascular diseases, hemiplegia, and severe renal, severe liver, and ulcer diseases were notable. 10 We did not find any significant association between outcome and co morbidities except for cerebrovascular insufficiency (P value < .05).…”

Section: Discussionmentioning

confidence: 99%

“…10,11 ICU admission also increased significantly with an increasing number of co morbid conditions among which Cardiovascular diseases, hemiplegia, and severe renal, severe liver, and ulcer diseases were notable. 10 We did not find any significant association between outcome and co morbidities except for cerebrovascular insufficiency (P value < .05). Therefore we can predict that admission diagnosis and other factors might play a vital role altogether in the outcomes of patients.…”

Section: Discussionmentioning

confidence: 99%

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Variation of adult admission and co-morbidity to general intensive care unit of BSMMU: Impact on outcome

et al. 2009

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A retrospective study was done in ICU of BSMMU during January to June 2007 with a total number of 157 patients. Patients were included from this hospital and also from private hospitals. In accordance of the criteria for analysis a structured questionnaire was used whereas data obtain from hospital record sheets and file. We observed admission diagnosis, co-morbidities, length of stay, different procedures and overall outcome. Among 157 Patients age group of 61-70 yrs. constitutes the major proportion, which was 20.4% and male was 61.8%. 108 patients (75.2%) were admitted due medical illness and among which respiratory failure was 15.3%, intracranial hemorrhage was 13.4%. Among 112 deaths 77 died after 96 hours of admission. Death occurred in 90.5% for non-traumatic hemorrhage and 94.1% cases for pneumonia (P<0.5). We did not find any significant association between outcome and co-morbidities except for cerebrovascular in sufficiency (P<0.5). Therefore we can predict that admission diagnosis and other factors

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Variation of adult admission and co-morbidity to general intensive care unit of BSMMU: Impact on outcome

et al. 2009

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“…37,38 In Olmsted County, Minnesota, in which Mayo Clinic, Rochester, is located, one in eight decedents received ICU care during a ter minal hospital admission. 39 The principles of withholding and withdrawing life-sustaining treatments in the ICU have been established, and there is a growing acceptance by medical staff, patients, and patients' families of the appropriateness of such action. 38,[40][41][42][43][44][45][46] The perceived probability of survival infl uences patient preferences regarding the desire to undergo CPR in the event of a cardiac arrest.…”

Section: Infl Uence Of Resuscitation Status On Model Performancementioning

confidence: 99%

Comparison of APACHE III, APACHE IV, SAPS 3, and MPM0III and Influence of Resuscitation Status on Model Performance

Keegan

Gajic

Afessa

2012

Chest

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The assessment of quality of care in the practice of medicine has become increasingly important. [1][2][3] The practice of critical care medicine has been especially scrutinized, at least in part because of the enormous costs of providing critical care services. 4,5 Aside from external pressures, monitoring and improvement of quality of care are important to clinicians. 6,7 Misuse of quality measures may occur and "[risks] stigmatizing an entire institution," 8 so it is imperative that any assessment of the quality of care delivered in the ICU involves a consideration of the severity of patient illness using a reliable measure. The Joint Commission 9 has proposed severity-adjusted mortality rate as a specifi c measure that should be recorded.Prognostic scoring systems have been developed by the critical care community in an effort to quantify the severity of illness of a given patient or group of patients. 10-12 Adjustment for severity of illness enables monitoring of the performance of an ICU over time and for comparison of ICUs in the same or different hospitals. It is imperative that such severity adjustments be as accurate as possible. 13 Many prognostic models exist, suggesting that the optimum model has not been established. The three most commonly used adult-ICU prognostic scoring systems are APACHE (Acute Physiology and Chronic Health Evaluation), the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Conclusions: APACHE III and IV had similar discriminatory capability and both were better than SAPS 3, which was better than MPM 0 III. The calibrations of the models studied were poor. Overall, models with more predictor variables performed better than those with fewer. The addition of resuscitation status did not improve APACHE III or IV or SAPS 3 prediction. CHEST 2012; 142(4):851 -858Abbreviations: APACHE 5 Acute Physiology and Chronic Health Evaluation; AUC 5 area under the receiver operator characteristic curve; DNR 5 do not resuscitate; MPM 5 Mortality Probability Model; ROC 5 receiver operating characteristic; SAPS 5 Simplifi ed Acute Physiology Score

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“…One in five to one in eight decedents received ICU care during a terminal hospitalization; end-of-life ICU use increased with increasing age and comorbidity. [5][6][7] This terminal ICU admission consumed 80% of all terminal hospitalization costs. 5 In particular, it has been suggested 3,8 that ICU use and mechanical ventilation may be ineffective in this setting.…”

mentioning

confidence: 99%

Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer

Sharma

Freeman

Zhang

et al. 2008

Chest

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Demographic and clinical variation of adult intensive care unit utilization from a geographically defined population

Abstract: Population-based rates of ICU admission and utilization in Olmsted County, Minnesota, increased with age and are highest in the very elderly. The presence of chronic illness, particularly cardiovascular conditions, significantly increases ICU utilization and risk of ICU admission.

Cited by 36 publications

References 44 publications

Variation of adult admission and co-morbidity to general intensive care unit of BSMMU: Impact on outcome

Variation of adult admission and co-morbidity to general intensive care unit of BSMMU: Impact on outcome

Comparison of APACHE III, APACHE IV, SAPS 3, and MPM0III and Influence of Resuscitation Status on Model Performance

Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer

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