The Impact of Implementing Critical Care Team on Open General Intensive Care Unit / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
; : 100-106, 2012.
Article
de En
| WPRIM
| ID: wpr-105219
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. METHODS: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. RESULTS: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). CONCLUSION: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Ventilation artificielle
/
Sevrage
/
Budgets
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Modèles logistiques
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Études prospectives
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Indice APACHE
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Soins de réanimation
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Unités de soins intensifs
Type d'étude:
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limites du sujet:
Humans
langue:
En
Texte intégral:
Tuberculosis and Respiratory Diseases
Année:
2012
Type:
Article