Volume 16 Supplement 1

32nd International Symposium on Intensive Care and Emergency Medicine

Open Access

Mortality and priority level for ICU admission in the setting of limited critical care beds in El Salvador

  • V Segura1,
  • NR Reyes1,
  • ME Tejada1 and
  • EM Zolano1
Critical Care201216(Suppl 1):P384

DOI: 10.1186/cc10991

Published: 20 March 2012

Introduction

In El Salvador there are a limited number of ICU beds. The ICU bed per inhabitant ratio is only 0.7 per 100,000 in a country with a population of 6,071,774 [1]. The aim of this study was to show the impact that the ICU bed deficit has on the mortality of the patients admitted to the internal medicine floor.

Methods

We conducted a descriptive, cross-sectional study. A nonprobabilistic sample was estimated using EPIDAT 4.0 (mortality rate 16%, 95% CI, P < 0.05). We enrolled 513 patients admitted to the Internal Medicine ward, from June to November 2011. All patients were evaluated using the ICU admission priority criteria of the Society of Critical Care Medicine (SCCM). We divide the patients into high priority (SCCM priority levels 1 and 2) and low priority (SCCM priority levels 3 and 4) for ICU admission. The probability of death using APACHE II score and mortality rate was calculated for each group, in order to obtain the Standardized Mortality Ratio (SMR). A t test and a Mantel-Haenszel test were used for statistical analysis between groups.

Results

A total of 513 patients were included in the study; 101 patients in the high priority group and 412 patients in the low priority group. There was a significantly higher mortality (P = 0.048) in the high priority level group especially with an APACHE score less than 9.0 (Figure 1).
https://static-content.springer.com/image/art%3A10.1186%2Fcc10991/MediaObjects/13054_2012_Article_328_Fig1_HTML.jpg
Figure 1

SMR according to APACHE II and SCCM criteria.

Conclusion

The study shows that there is an increased mortality rate in patients with high priority level for admission to the ICU with an APACHE II score less than 9 points. This represents 90 patients/year whose survival and prognosis could be improved by increasing the number of ICU beds available.

Authors’ Affiliations

(1)
Hospital San Rafael

References

Copyright

© Segura et al.; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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