APACHE II Archives - Critical Care Science (CCS)
Abstract
Rev Bras Ter Intensiva. 2006;18(1):18-21
DOI 10.1590/S0103-507X2006000100004
BACKGROUND AND OBJECTIVES: The aim of this study was to analyze the morbidity and the mortality of critically ill patients admitted to the intensive care unit in a teaching hospital, using the APACHE II score. METHODS: Descriptive and retrospective study, with analysis of 300 patients admitted to ICU from March 2004 to July 2005. RESULTS: Of the 300 patients admitted to ICU, 51.7% were men, average 54.2 ± 19.57 years and 78% from the wards of the teaching hospital itself. There was more prevalence of patients aged 60 years or older (43%). The main dysfunctions were from the respiratory and cardiocirculatory systems. Length of stay in ICU was 7.51 ± 8.21 days. The mean of APACHE II was 16.48 ± 7.67, with meaningful difference between survivors and deceased patients. The real mortality rate in ICU was 32.7%, without meaningful difference between patients that died before or after 48 hours. The standardized mortality ratio was 1.1. CONCLUSIONS: Despite the severity of the patients admitted to ICU, the standardized mortality ratio suggests a satisfactory quality in the service.
Abstract
Rev Bras Ter Intensiva. 2006;18(1):18-21
DOI 10.1590/S0103-507X2006000100004
BACKGROUND AND OBJECTIVES: The aim of this study was to analyze the morbidity and the mortality of critically ill patients admitted to the intensive care unit in a teaching hospital, using the APACHE II score. METHODS: Descriptive and retrospective study, with analysis of 300 patients admitted to ICU from March 2004 to July 2005. RESULTS: Of the 300 patients admitted to ICU, 51.7% were men, average 54.2 ± 19.57 years and 78% from the wards of the teaching hospital itself. There was more prevalence of patients aged 60 years or older (43%). The main dysfunctions were from the respiratory and cardiocirculatory systems. Length of stay in ICU was 7.51 ± 8.21 days. The mean of APACHE II was 16.48 ± 7.67, with meaningful difference between survivors and deceased patients. The real mortality rate in ICU was 32.7%, without meaningful difference between patients that died before or after 48 hours. The standardized mortality ratio was 1.1. CONCLUSIONS: Despite the severity of the patients admitted to ICU, the standardized mortality ratio suggests a satisfactory quality in the service.
Abstract
Rev Bras Ter Intensiva. 2006;18(2):114-120
DOI 10.1590/S0103-507X2006000200002
BACKGROUND AND OBJECTIVES: Information on the outcomes of patients who were refused to the ICU is limited. The aims of this study were to compare the clinical characteristics of patients who were admitted with those of patients who were refused to the ICU and to identify clinical parameters associated with triage procedures. METHODS: Observational prospective cohort study. The following data were collected using a standard questionnaire: comorbidities, acute illness, vital status, laboratory data and APACHE II score. The end-points of interest were admission to the ICU and vital status at hospital discharge. RESULTS: A total of 455 patients were studied; 254 (56%) were admitted and 201 (44%) were not. The main reason for the refuse of admission was the lack of ICU beds (82%). Patients who were not admitted had a higher mortality (85% vs. 61%; p < 0.001). In multivariable analysis, the following variables were associated to non-admission [odds ratio, (95% confidence interval)]: metastatic cancer [5.6(1.7-18.7)], arterial systolic pressure < 90 mmHg [5.2(3.0-8.8)], age > 70 years [4.0(2.4-6.5)], hepatic cirrhosis [3.7(1.8-7.6)], and Glasgow coma scale < 5 [3.6(1.9-6.9)]. The variables associated with ICU admission were: mechanical ventilation [0.5(0.3-0.7)] and acute coronary syndromes [0.1(0.03-0.6)]. CONCLUSIONS: Refusal of ICU admission is frequent and generally as a consequence of ICU beds shortage. Patients who were not admitted had a higher mortality. Clinical characteristics associated with the refusal of admission were identified suggesting that they are used in clinical decision-making for ICU triage.
Abstract
Rev Bras Ter Intensiva. 2006;18(2):114-120
DOI 10.1590/S0103-507X2006000200002
BACKGROUND AND OBJECTIVES: Information on the outcomes of patients who were refused to the ICU is limited. The aims of this study were to compare the clinical characteristics of patients who were admitted with those of patients who were refused to the ICU and to identify clinical parameters associated with triage procedures. METHODS: Observational prospective cohort study. The following data were collected using a standard questionnaire: comorbidities, acute illness, vital status, laboratory data and APACHE II score. The end-points of interest were admission to the ICU and vital status at hospital discharge. RESULTS: A total of 455 patients were studied; 254 (56%) were admitted and 201 (44%) were not. The main reason for the refuse of admission was the lack of ICU beds (82%). Patients who were not admitted had a higher mortality (85% vs. 61%; p < 0.001). In multivariable analysis, the following variables were associated to non-admission [odds ratio, (95% confidence interval)]: metastatic cancer [5.6(1.7-18.7)], arterial systolic pressure < 90 mmHg [5.2(3.0-8.8)], age > 70 years [4.0(2.4-6.5)], hepatic cirrhosis [3.7(1.8-7.6)], and Glasgow coma scale < 5 [3.6(1.9-6.9)]. The variables associated with ICU admission were: mechanical ventilation [0.5(0.3-0.7)] and acute coronary syndromes [0.1(0.03-0.6)]. CONCLUSIONS: Refusal of ICU admission is frequent and generally as a consequence of ICU beds shortage. Patients who were not admitted had a higher mortality. Clinical characteristics associated with the refusal of admission were identified suggesting that they are used in clinical decision-making for ICU triage.
Abstract
Rev Bras Ter Intensiva. 2007;19(3):348-353
DOI 10.1590/S0103-507X2007000300014
BACKGROUND AND OBJECTIVES: Each intensive care units result has to be observed in the context of medical care, as well as the institution witch it belongs. There are many types of prognostic index in intensive care. The APACHE II was introduced by Knaus et al. in 1985, being a widely used system to evaluate the illness severity in intensive care patients. This objective was evaluated the prognostic index (APACHE II) in patients submitted to elective or emergency gastrointestinal surgery admitted to the ICU. METHODS: Medical school intensive care unit. It was collected the following data: age, sex, length of stay, intensive care indication, type of surgery (elective or emergency), body mass index (BMI) APACHE II and predicted mortality. RESULTS: A total of 38 patients data were collected during the period of April 2005 to April 2006. Eighteen patients died and twenty survived. The age of the non-survivors varied from 44 to 92 (mean age 66.6); while the age of the survivors varied from 28 to 78 (mean age 59. 1). The BMI of the non-survivors varied from 22 to 29 (mean body mass index 26) while in the other group the mean body mass index was 25. 6. No significant difference was noted in the age and body mass index of both groups. The length of stay varied from 2 to 52 days in the non-survivors group (mean 11.3 days), while in the survivors group varied from 1 to 30 days (mean 4.9). The APACHE II varied from 5 to 32 in the non-survivors group (mean 19.14). While in the survivors group varied from 1 to 18 (mean 8.6). The length of stay and APACHE II demonstrated a significant difference in both groups, being higher in the non-survivors group. The non-survivors predicted mortality varied from 3.1 to 84.9 (mean 38.8); while the survivors mean was 7.5. The Standardized Mortality Rate in this study was 1.22. CONCLUSIONS: Non-survivors patients APACHE II was higher than the survivors; the SMR was similar to others studies; the length of stay was longer in the non-survivors group; no statistic difference was noted in the body mass index.
Abstract
Rev Bras Ter Intensiva. 2007;19(3):348-353
DOI 10.1590/S0103-507X2007000300014
BACKGROUND AND OBJECTIVES: Each intensive care units result has to be observed in the context of medical care, as well as the institution witch it belongs. There are many types of prognostic index in intensive care. The APACHE II was introduced by Knaus et al. in 1985, being a widely used system to evaluate the illness severity in intensive care patients. This objective was evaluated the prognostic index (APACHE II) in patients submitted to elective or emergency gastrointestinal surgery admitted to the ICU. METHODS: Medical school intensive care unit. It was collected the following data: age, sex, length of stay, intensive care indication, type of surgery (elective or emergency), body mass index (BMI) APACHE II and predicted mortality. RESULTS: A total of 38 patients data were collected during the period of April 2005 to April 2006. Eighteen patients died and twenty survived. The age of the non-survivors varied from 44 to 92 (mean age 66.6); while the age of the survivors varied from 28 to 78 (mean age 59. 1). The BMI of the non-survivors varied from 22 to 29 (mean body mass index 26) while in the other group the mean body mass index was 25. 6. No significant difference was noted in the age and body mass index of both groups. The length of stay varied from 2 to 52 days in the non-survivors group (mean 11.3 days), while in the survivors group varied from 1 to 30 days (mean 4.9). The APACHE II varied from 5 to 32 in the non-survivors group (mean 19.14). While in the survivors group varied from 1 to 18 (mean 8.6). The length of stay and APACHE II demonstrated a significant difference in both groups, being higher in the non-survivors group. The non-survivors predicted mortality varied from 3.1 to 84.9 (mean 38.8); while the survivors mean was 7.5. The Standardized Mortality Rate in this study was 1.22. CONCLUSIONS: Non-survivors patients APACHE II was higher than the survivors; the SMR was similar to others studies; the length of stay was longer in the non-survivors group; no statistic difference was noted in the body mass index.