Why the surgical patients are so critical in their intensive care unit arrival?

Acta Cirurgica Brasileira

Anibal Basile-filho²  Mayra Gonçalves Menegueti¹  Maria Auxiliadora-martins²  Edson Antonio Nicolini² 

[1] ,University of São Paulo Ribeirão Preto Medical School Department of Surgery and AnatomyRibeirão Preto SP ,Brazil

关键词: APACHE;    Patient Transfer;    Mortality;    Intensive Care;    APACHE;    Tranferência de Pacientes;    Mortalidade;    Cuidados Intensivos;   

DOI  :  10.1590/S0102-86502013001300010

来源: SciELO

【 摘 要 】

PURPOSE: To assess the ability of the Acute Physiology and Chronic Health Evaluation II (APACHE II) to stratify the severity of illness and the impact of delay transfer to an Intensive Care Unit (ICU) on the mortality of surgical critically ill patients. METHODS: Five hundred and twenty-nine patients (60.3% males and 39.7% females; mean age of 52.8 ± 18.5 years) admitted to the ICU were retrospectively studied. The patients were divided into survivors (n=365) and nonsurvivors (n=164). APACHE II and death risk were analysed by generation of receiver operating characteristic (ROC) curves. The interval time between referral and ICU arrival was also registered. The level of significance was 0.05. RESULTS: The mean APACHE II and death risk was 19.9 ± 9.6 and 37.7 ± 28.9%, respectively. The area under the ROC curve for APACHE II and death risk was 0.825 (CI = 0.765-0.875) and 0.803 (CI = 0.741-0.856). The overall mortality (31%) increased progressively with the delay time to ICU transfer, as also evidencied by the APACHE II score and death risk. CONCLUSION: This investigation shows that the longer patients wait for ICU transfer the higher is their criticallity upon ICU arrival, with an obvious negative impact on survival rates.

【 授权许可】

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