Hoge mortaliteit na onstlag van IC in ziekenhuizen zonder HDU (high dependence facility)

Bibliotheek (Redactie Bibliotheek) donderdag 1 januari 2009, 15:53
Thema's:

Smith L, Orts CM, O'Neil I, Batchelor AM, Gascoigne AD, Baudouin SV. TISS and mortality after discharge from intensive care. Intensive Care Med 1999 Oct;25(10):1061-5

DOELSTELLING: Onderzoeken wat het effect is van hoge niveaus van pre-intensive care unit (ICU) ontslagzorg, zoals beoordeeld door de Therapeutic Intervention Scoring System (TISS), op latere ziekenhuis mortaliteit. DESIGN: Een 1-jarige prospectieve, observationele studie.

OBJECTIVE: To examine the effect of high levels of pre-intensive care unit (ICU) discharge care, as assessed by the Therapeutic Intervention Scoring System (TISS), on subsequent hospital mortality. DESIGN: A 1-year prospective, observational study. SETTING: The ICU and wards of a university teaching hospital with no high dependency facility (HDU). PATIENTS: A total of 283 patients were discharged to hospital wards between July 1997 and June 1998. ++RESULTS: 11 % of all ICU discharges subsequently died in hospital. Patients discharged with a TISS of 20 or greater had a 21.4 % mortality compared to 3.7 % for those with a TISS of less than 10. Increasing age, Acute Physiology Score (APS) on admission and male sex were also significantly associated with post-discharge death. CONCLUSIONS: In a hospital without HDU facilities, patients who are receiving HDU levels of care on discharge from the ICU have a high in-hospital mortality

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