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.