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Implementing an intensive care registry in India: preliminary results of the case-mix program and an opportunity for quality improvement and research.
Adhikari, Neill K J; Arali, Rajeshwari; Attanayake, Udara; Balasundaram, Sampath; Beane, Abi; Chakravarthy, Vijay; Channanath Ashraf, Niyaz; Darshana, Sri; Devaprasad, Dedeepiya; Dondorp, Arjen M; Fowler, Robert; Haniffa, Rashan; Ishani, Pramodya; James, Augustian; Jawad, Issrah; Jayakumar, Devachandran; Kodipilly, Chamira; Laxmappa, Rakesh; Mangal, Kishore; Mani, Ashwin; Mathew, Meghena; Patodia, Sristi; Pattnaik, Rajyabardhan; Priyadarshini, Dilanthi; Pulicken, Mathew; Rabindrarajan, Ebenezer; Ramachandran, Pratheema; Ramesh, Kavita; Rani, Usha; Ranjit, Suchitra; Ramaiyan, Ananth; Ramakrishnan, Nagarajan; Ranganathan, Lakshmi; Rashan, Thalha; Dominic Savio, Raymond; Selva, Jaganathan; Tirupakuzhi Vijayaraghavan, Bharath Kumar; Tripathy, Swagata; Tolppa, Timo; Udayanga, Ishara; Venkataraman, Ramesh; Vijayan, Deepak.
Afiliação
  • Adhikari NKJ; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Arali R; Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Attanayake U; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Balasundaram S; Critical Care Medicine, Apollo Children's Hospital, Chennai, India.
  • Beane A; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Chakravarthy V; Chennai Critical Care Consultants, Chennai, India.
  • Channanath Ashraf N; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Darshana S; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Devaprasad D; Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Dondorp AM; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Fowler R; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Haniffa R; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Ishani P; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • James A; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Jawad I; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Jayakumar D; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Kodipilly C; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Laxmappa R; Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Mangal K; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Mani A; Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Mathew M; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Patodia S; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Pattnaik R; Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.
  • Priyadarshini D; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Pulicken M; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Rabindrarajan E; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Ramachandran P; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Ramesh K; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Rani U; Chennai Critical Care Consultants, Chennai, India.
  • Ranjit S; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Ramaiyan A; Network for Improving Critical care Systems and Training, NICST, Colombo, Sri Lanka.
  • Ramakrishnan N; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Ranganathan L; Critical Care Medicine, Nanjappa Hospital, Shimoga, India.
  • Rashan T; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Dominic Savio R; Critical Care Medicine, Eternal Hospitals, Jaipur, India.
  • Selva J; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Tirupakuzhi Vijayaraghavan BK; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Tripathy S; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Tolppa T; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Udayanga I; Indian Registry of IntenSive care, IRIS, Chennai, India.
  • Venkataraman R; Critical Care Medicine, Apollo Hospitals, Chennai, India.
  • Vijayan D; Indian Registry of IntenSive care, IRIS, Chennai, India.
Wellcome Open Res ; 5: 182, 2020.
Article em En | MEDLINE | ID: mdl-33195819
ABSTRACT

Background:

The epidemiology of critical illness in India is distinct from high-income countries. However, limited data exist on resource availability, staffing patterns, case-mix and outcomes from critical illness. Critical care registries, by enabling a continual evaluation of service provision, epidemiology, resource availability and quality, can bridge these gaps in information. In January 2019, we established the Indian Registry of IntenSive care to map capacity and describe case-mix and outcomes. In this report, we describe the implementation process, preliminary results, opportunities for improvement, challenges and future directions.

Methods:

All adult and paediatric ICUs in India were eligible to join if they committed to entering data for ICU admissions. Data are collected by a designated representative through the electronic data collection platform of the registry. IRIS hosts data on a secure cloud-based server and access to the data is restricted to designated personnel and is protected with standard firewall and a valid secure socket layer (SSL) certificate. Each participating ICU owns and has access to its own data. All participating units have access to de-identified network-wide aggregate data which enables benchmarking and comparison.

Results:

The registry currently includes 14 adult and 1 paediatric ICU in the network (232 adult ICU beds and 9 paediatric ICU beds). There have been 8721 patient encounters with a mean age of 56.9 (SD 18.9); 61.4% of patients were male and admissions to participating ICUs were predominantly unplanned (87.5%). At admission, most patients (61.5%) received antibiotics, 17.3% needed vasopressors, and 23.7% were mechanically ventilated. Mortality for the entire cohort was 9%.  Data availability for demographics, clinical parameters, and indicators of admission severity was greater than 95%.

Conclusions:

IRIS represents a successful model for the continual evaluation of critical illness epidemiology in India and provides a framework for the deployment of multi-centre quality improvement and context-relevant clinical research.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Revista: Wellcome Open Res Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Índia

Texto completo: 1 Base de dados: MEDLINE Idioma: En Revista: Wellcome Open Res Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Índia