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Signa vitae : journal for intesive care and emergency medicine, Vol. 7 No. 1, 2012.

Izvorni znanstveni članak

Observed versus predicted hospital mortality in general wards patients assisted by a medical emergency team

Giovanni Landoni orcid id orcid.org/0000-0002-8594-5980 ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Luca Cabrini ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Giacomo Monti ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Valentina Paola Plumari ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Stefano Turi ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Pasin Laura ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Paolo Silvani ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Sergio Colombo ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)
Alberto Zangrillo ; Department of Anaesthesiology and Intensive Care, Università Vita-Salute San Raffaele, IRCCS San Raffaele, Via Olgettina 60, 20132 Milan (Italy)

Puni tekst: engleski pdf 57 Kb

str. 38-42

preuzimanja: 785

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Sažetak

Introduction. In many countries the demand for intensive care beds exceeds their availability. The Medical Emergency Team (MET) can manage critically ill patients outside the intensive care unit (ICU). Hospital mortality rate for patients admitted to general wards and assisted by the MET was never compared to the predicted mortality for the same group of patients in an ICU setting. Methods. Single-centre, prospective, observational study on consecutive adult patients assisted by the MET in all general wards and in the Emergency Department of a 1100-bed teaching Hospital. Patients with a 'do-not-attempt-resuscitation' decision were excluded. Results. Eighty-two consecutive patients were included. Observed hospital mortality was 34.1% (28 patients), while the Simplified Acute Physiology Score II (SAPS II) predicted a mortality for the first MET visit of 17% (p=0.02). Patients transferred to an ICU, but not during the first MET evaluation (delayed ICU admission), had worse than predicted outcomes, while patients immediately transferred to an ICU showed hospital mortality similar to the predicted one. The fifty patients treated for acute respiratory failure (especially those with pneumonia - 12 patients) had the worst observed/predicted hospital mortality ratio (3.0 for acute respiratory failure, p=0.02; 8.06, p=0.03 for pneumonia patients). Conclusions. Critically ill patients who remained in general wards or who were admitted to the ICU with some delay had markedly higher hospital mortality than the SAPS II predicted hospital mortality, even if they were assisted by the MET.

Ključne riječi

medical emergency team; rapid response system; intensive care unit; critical care

Hrčak ID:

81737

URI

https://hrcak.srce.hr/81737

Datum izdavanja:

1.4.2012.

Posjeta: 1.504 *