当前位置： SCI文献检索 > JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA期刊下所有文献 > Changes in intensive care unit performance measures associated with opening a dedicated thoracic surgical progressive care unit.

Changes in intensive care unit performance measures associated with opening a dedicated thoracic surgical progressive care unit.

Abstract：

OBJECTIVES:To determine the effect of the introduction of a specialty-specific progressive care unit (PCU) on the intensive care unit (ICU) to which relatively low-acuity patients had previously been admitted. DESIGN:Retrospective cohort study. SETTING:The thoracic (noncardiac) surgical ICU of a tertiary referral institution. PATIENTS:Four thousand fifty-three patients admitted to the ICU after thoracic surgery between October 1994 and December 2003. INTERVENTIONS:None. MEASUREMENTS AND RESULTS:The institutional Acute Physiology and Chronic Health Evaluation (APACHE) III database was searched to compare the number of admissions, severity of illness, mortality, and other aspects of care for periods before and after the introduction of the PCU. Patients in the post-PCU group were more severely ill by APACHE criteria. The ICU mortality rates for the periods before and after the introduction of the PCU were 1.14% (32/2,801 patients) and 7.27% (91/1,252 patients), respectively. The performance of the ICU appeared to be worse in the period after the opening of the PCU. The ICU- and hospital-customized standardized mortality ratio increased from 0.68 (95% confidence interval [CI], 0.47-0.96) in the pre-PCU group to 1.20 (95% CI, 0.96-1.47) in the post-PCU group and from 0.83 (95% CI, 0.66-1.03) to 1.24 (95% CI, 1.05-1.46). CONCLUSIONS:The introduction of a nonintensivist-directed PCU to care for thoracic surgical patients had a significant impact on the parent ICU. Of concern is that outcome and quality measures appeared to worsen and ICU readmission rate increased.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Keegan MT,Brown DR,Thieke MP,Afessa B

doi

10.1053/j.jvca.2007.12.015

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

347-53

issue

3

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(07)00399-0

journal_volume

22

pub_type

杂志文章

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