Autori: Monica Magnusson
Ustanova zaposlenja: SWEDEN
Ključne riječi: Intensive care, icu admission, icu discharge
Kongres/Simpozij: ”5. Međunarodni kongres HDMSARIST-a” i ”8. Međunarodni koongres WFCCN-a”
Mjesto i vrijeme održavanja: Šibenik, 12.-15. travnja 2012. godine
Background:
The ICU admission diagnosis is important when studying patient outcomes (1),
yet this information may be gleaned from multiple sources. The extent to which
these sources are consistent in the Swedish setting is not known, yet the
choice of which source to use has the potential to influence critical care
research.
Objectives: To examine similarities/differences in: reason for admittance as
measured by 1) APACHE II reason for admission, 2) main ICU diagnosis documented
by the intensivist, and 3) the summary hospital diagnosis documented by the
ward physician.
Methods: This methodological study involved a retrospective analysis of
prospectively gathered data during 2000-2005 from three ICU´s in Sweden. Out of
1,663 patients alive at 6 months 980 (59%) participated. The diagnoses were
obtained from: the ICU database (APACHE II reason for admittance; main ICU
diagnosis) and the Swedish national inpatient registry (main hospital
diagnosis).
Results: APACHE II reason for admission and main hospital diagnosis were
identical in 566 cases (57.8%). The main hospital diagnosis was the same as the
summary hospital diagnosis in 579 cases (59.1%). Finally, APACHE II reason for
ICU admittance and the summary hospital diagnosis were identical in 611 cases
(62.3%). No differences in these comparisons between hospitals were identified.
Conclusions: For ICU outcome studies it is important to be aware of that
diagnoses assigned at admittance, for the ICU stay and for the whole hospital
stay to a large extent may be different. Careful consideration of the
appropriate measure to use in research is required.
Reference: 1.Cuthbertson B, Roughton S, Jenkinson D, et al. Quality of life in
the five years after intensive care: a cohort study. Critical Care 2010;14:R6.