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Mortality and outcome in different subgroups of patients admitted in an ICU

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Introduction

SOFA and SAPS II scoring is used for monitoring of organ function and outcome prediction in intensive care. We evaluated the use of these scores to analysis the different subgroups of patients admitted to our ICU.

Methods

Over a period of nine months (between October 1998 and June 1999), the first five days scores of SOFA and SAPS II, were prospectively calculated for all consecutive patients (length of ICU stay >12 h) admitted to our 10-bed medical-surgical ICU. We stratified patients using three different subgroups: 1) medical (M); 2) surgical, elective (E); 3) surgical, unscheduled (U). Organ failure if SOFA score ≥ 3. Mortality was assessed at ICU discharge. Data analysis and statistics were performed using the Statistical Package for Social Sciences (SPSS) version 6.0.1 for Windows.

Results

278 patients, aged 58.5± 18.4 years, were included in the study. In this cohort of patients, the median length of ICU stay was 7.8± 14.6 days, SAPSII 29.1± 13.5 (median 27), SOFA 5± 3.75 (4), and the ICU mortality rate was 19.8%. Relation between SOFA/SAPSII at admission and ICU discharged: non-survivors-SOFA 8.3± 4.3 (8), SAPSII 40.6± 13.9 (39); survivors-SOFA 4.25± 3.13 (3.5), SAPSII 26.3± 11.8 (24.5). In the three different subgroups we have: (M)-73 patients (26.2%), length of stay 13.78± 20.98 (median 6), SAPSII 33.9± 12.6 (32), SOFA 5.37± 3.7(4), mortality rate 30.1%; (E)-150 patients (54%) length of stay 3.89± 8.05 (1), SAPSII 23.3± 10.2 (22), SOFA 4.43± 3.5 (4), mortality rate 10%; (U)-55 patients (19.8%) length of stay 10.47± 15.47 (5), SAPSII 38.7± 4.07 (38), SOFA 6.29± 4.07 (6), mortality rate 32.7%. The mortality rate increased with the number of failing organs present at the time of admission (7.6% with no organ failure, and 100% with 5 organs failure). The evaluation of a subgroup of 100 patients who stayed in the ICU for at least 5 days showed: length of stay 18.53± 20.4, SAPSII 35.49± 10.9, SOFA 6.76± 3.75 (7), mortality rate 34%. Subgroups: (M)-57%; (E)-25%; (U)-28%.

Conclusion

We have in our ICU two subgroups of patients: 1) medical (M) and unscheduled surgery (E) with higher length of stay, higher scores, and higher mortality rate, compared with the second group-elective surgery(E). This is especially important when we try to compare the performance of different ICUs.

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Marinho, A., Luzio, J., Prospero, F. et al. Mortality and outcome in different subgroups of patients admitted in an ICU. Crit Care 4 (Suppl 1), P224 (2000). https://doi.org/10.1186/cc943

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  • DOI: https://doi.org/10.1186/cc943

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