Data from the U.S. Army field surgical hospital intensive care unit in post-war Kosovo

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Objective

To review the admissions to the intensive care unit in a military field surgical hospital to determine the relationships, if any, between demographics, severity of illness, length of stay, ventilatory duration, and other parameters for operative and non-operative trauma, non-trauma surgical, and medical admissions.

Design

Prospective observational study.

Setting

U.S. Army 67th Combat Support Hospital intensive care unit deployed to a forward field location in the U.S. Sector in post-war Kosovo in support of the NATO peacekeeping mission in that region.

Patients

All fifty-five patients admitted to the intensive care unit from July through November, 1999 were enrolled in the study.

Interventions

None.

Measurements and main results

Therapeutic Intervention Scoring System (TISS) Scores for each patient were determined at admission and at discharge. Other data collected included demographic data, including nationality, age, and gender; diagnosis; length of stay; duration of ventilatory support, if applicable; and disposition at discharge.

Conclusions

The majority (68%) of patient admissions were for trauma. Patient age ranged from 1 day to 76 years. Sixty-two percent of patients were 42 years of age or younger. Mean length of stay was 1.70 days. Seventy-one percent of patients were local national (Kosovo) patients, and 29% were NATO personnel. Mean TISS scores for trauma, non-trauma surgical, and medical admissions were 21.67, 17.00, and 9.53, respectively. There was a positive correlation between TISS score at admission and length of stay for all patient categories. Mean delta TISS scores between admission and discharge were 12.14, 8.00, and 5.00 for trauma, non-trauma surgical, and medical admissions respectively. Patients who remained on the ventilator for prolonged periods had higher TISS scores at admission (mean 36.71) than the population overall (mean 18.23). Length of stay was determined by many variables, including severity of illness, diagnosis, availability of host nation facilities for local patient transfers, and urgency of evacuation for military and other NATO personnel.