Influence of time elapsed from end of emergency surgery until admission to intensive care unit, on Acute Physiology and Chronic Health Evaluation II (APACHE II) prediction and patient mortality rate

CONTEXT AND OBJECTIVE: Patients are often admitted to intensive care units with delay in relation to when this service was indicated. The objective was to verify whether this delay influ- ences hospital mortality, length of stay in the unit and hospital, and APACHE II prediction. DESIGN AND SETTING:...

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Detalles Bibliográficos
Autores: Chiavone, Paulo Antonio, Rasslan, Samir
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2005
País:Brasil
Institución:Associação Paulista de Medicina
Repositorio:São Paulo medical journal (Online)
Idioma:inglés
OAI Identifier:oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/2343
Acceso en línea:https://periodicosapm.emnuvens.com.br/spmj/article/view/2343
Access Level:acceso abierto
Palabra clave:APACHE
Unidades de terapia intensiva
Prognóstico
Fatores de tempo
Mortalidade hospitalar
Intensive care units
Prognosis
Time factors
Hospital mortality
Descripción
Sumario:CONTEXT AND OBJECTIVE: Patients are often admitted to intensive care units with delay in relation to when this service was indicated. The objective was to verify whether this delay influ- ences hospital mortality, length of stay in the unit and hospital, and APACHE II prediction. DESIGN AND SETTING: Prospective and accuracy study, in intensive care unit of Santa Casa de São Paulo, a tertiary university hospital. METHODS: We evaluated all 94 patients admitted following emergency surgery, from August 2002 to July 2003. The variables studied were APACHE II, death risk, length of stay in the unit and hospital, and hospital mortality rate. The patients were divided into two groups accord- ing to the time elapsed between end of surgery and admission to the unit: up to 12 hours and over 12 hours. RESULTS: The groups were similar regarding gender, age, diagnosis, APACHE II score and hospital stay. The death risk factors were age, APACHE II and elapsed time (p < 0.02). The mortality rate for the over 12-hour group was higher (54% versus 26.1%; p = 0.018). For the over 12-hour group, observed mortality was higher than expected mortality (p = 0.015). For the up to 12-hour group, observed and expected mortality were similar (p = 0.288). CONCLUSION: APACHE II foresaw the mortality rate among patients that arrived faster to the intensive care unit, while the mortality rate was higher among those patients whose admission to the intensive care unit took longer.