Ward mortality after ICU discharge: a multicenter validation of the Sabadell score

Fernández, Rafael; Serrano, José Manuel Flores; Umaran, Isabel; Abizanda, R.; Carrillo, Andrés; López-Pueyo, M.J.; Sedes, Pedro Rascado; Balerdi, B.; Suberviola, Borja; Hernández, Gónzalo

doi:10.1007/s00134-010-1825-5

Cited by 58 publications

(56 citation statements)

References 14 publications

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“…These differences may also be due to differences in safety and quality of health care services among different health care facilities. Survival is the main endpoint that is considered important for patients and society (Fernandez et al, 2010). Mortality is a clinical outcome which is easy to define and measure using empirical methods and mortality following ICU discharge is a quality indicator and frequently a predicted event (Fernandez et al, 2006;Frick et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Obsa¹,

Adem²,

Gete³

2017

Int. J. Med. Med. Sci.

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An intensive care unit is a special department of hospital or health care facility that provides intensive treatment medicine. Critically ill patients are admitted to the intensive care unit to reduce morbidity and mortality associated with acute illness, trauma or surgical procedures. This study aimed to assess clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna from January 2015 to January 2016. Institutional based cross sectional study design was conducted. All the study participants admitted to intensive care unit were included. Regular supervision and follow up was made. Data was entered into Epi info version 7 by investigators and was transported to SPSS version 20 for analysis. Bivariate and multivariate analysis was used to identify factors associated with patient's outcome. A total of 280 clients were enrolled into the study of which 46.42% died. About 26% of patients were found in the age group of 20 to 24 years and majority of them were male (58.2%). Patient with head injury is about six times more likely to die in the intensive care unit than patients with small bowel obstruction (AOR 6.620 (95% CI ((468-93.584). There were poor outcomes of patients admitted to intensive care unit so that it was strongly recommended to improve quality of care.Key word: Ethiopia, intensive care unit, cause of death, hospital discharge.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Obsa¹,

Adem²,

Gete³

2017

Int. J. Med. Med. Sci.

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“…Characterizing the risk profiles of intensive care units. InThey have validated the relevance of the Sabadell score as a method for classifying patient's ward survival at discharge from the ICU [74] and even found an association of the Sabadell score with ICU readmission. Unfortunately, the lack of reliable predictors of ICU readmission prevents the clinical efficacy of this variable.…”

Section: Readmission?mentioning

confidence: 86%

Intensive care performance: How should we monitor performance in the future?

Timmers¹

2014

WJCCM

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Intensive care faces economic challenges. Therefore, evidence proving both effectiveness and efficiency, i.e. , cost-effectiveness, of delivered care is needed. Today, the quality of care is an important issue in the health care debate. How do we measure quality of care and how accurate and representative is this measurement? In the following report, several topics which are used for the evaluation of intensive care unit (ICU) performance are discussed: (1) The use of general outcome prediction models to determine the risk of patients who are admitted to ICUs in an increasing variety of case mix for the different intensive care units, together with three major limitations; (2) As critical care outcomes research becomes a more established entity, mortality is now only one of many endpoints that are relevant. Mortality is a limited outcome when assessing critical care performance, while patient interest in quality of life outcomes is relevant; and (3) The Quality Indicators Committee of the Society of Critical Care Medicine recommended that short-term readmission is a major performance indicator of the quality of intensive care medicine.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words:Intensive care performance; Quality of care; Critical care; Intensive care medicine Core tip: Variations in case mix, intensive care unit (ICU) demographics, clinical and non-clinical factors not addressed by the present severity of illness scores must be quantified to improve the accuracy of future prediction models. A completely different benefit using health-related quality of life (HrQoL) as a performance benchmark could be the follow-up evaluation of the patient's health status after ICU or hospital discharge. The moment when outcome research can predict the short-term (ICU discharge) QoL of a critically ill patient during the first 24 h of ICU admission will give physicians and health care policy makers an up-to-date and reliable evaluation of quality of care in the ICU for the future.Timmers TK, Verhofstad MHJ, Moons KGM, Leenen LPH. Intensive care performance: How should we monitor performance in the future? World J Crit Care Med 2014; 3(4): 74-79 Available from:

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“…La MHPU que observamos en este estudio está en consonancia con otros estudios publicados 7,12,[17][18][19] y en ella intervienen, además del tipo de alta, otros factores que también forman parte de las características de estas altas. Así, la mayor disfunción orgánica de los pacientes dados de alta no programada es reflejo de la incompleta resolución de los procesos que afectan a estos pacientes 20 , traduce una mayor necesidad de cargas de trabajo de enfermería 5 e indica que este tipo de alta es inapropiado o incluso precoz.…”

Section: Discussionunclassified

“…Como en el estudio de Fernández et al 7 , las readmisiones en UCI también están asociadas a la MHPU. De igual manera que las altas nocturnas en el estudio de Goldfrad y Rowan 8 , las altas no programadas no llevan aparejada mayores tasas de readmisión en UCI.…”

Section: Discussionunclassified

“…Sean cuales sean los factores que intervienen en ella, este tipo de alta no programada puede caer dentro del concepto de alta prematura o inapropiada por la persistencia de la gravedad y de las disfunciones orgánicas que presentan los pacientes en el momento de producirse, comprometiéndose el resultado final de la asistencia prestada a estos 5,6 . Recientemente, se ha validado una escala subjetiva que podría ayudar a la toma de este tipo de decisiones y a minimizar los riesgos 7 . Este tipo de alta no programada no ha sido estudiado específicamente, aunque en algunos estudios sobre altas nocturnas o en fin de semana se refiera que una gran mayoría de ellas son impulsadas por una nueva admisión [8][9][10][11] .…”

Section: Introductionunclassified

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Impacto de las altas no programadas en la mortalidad hospitalaria tras la estancia en una unidad de cuidados intensivos

et al. 2011

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ORIGINALImpacto de las altas no programadas en la mortalidad hospitalaria tras la estancia en una unidad de cuidados intensivos ResumenObjetivos: Comprobar la frecuencia de altas no programadas y su relación con la mortalidad hospitalaria tras la estancia en UCI. Diseño: Registro prospectivo de los ingresos de 6 años consecutivos. Análisis retrospectivo de la primera admisión de la cohorte de los supervivientes a UCI. Ámbito: UCI polivalente de 10 camas en hospital general de segundo nivel con 540 camas. Pacientes: 1.521 pacientes con más de 12 horas de estancia, dados de alta vivos y con desenlace hospitalario conocido.Intervenciones: Ninguna. Principales variables de interés: Se registró el tipo de alta de la unidad, normal o no programada, y se exploró su relación con la mortalidad hospitalaria post-UCI, las tasas de readmisión y la estancia hospitalaria post-UCI. Resultados: Hubo 165 altas no programadas (10,8%). La tasa de mortalidad fue del 11,6% (176 pacientes). Los factores relacionados con la mortalidad fueron la limitación del esfuerzo terapéutico (OR = 14,02 [4,6]), las readmisiones (OR = 3,46 [1,78]), las altas no programadas (OR = 2,16 [1,41]), la puntuación de fallos orgánicos al alta de UCI (OR = 1,16 [1,01-1,32]) y la edad (OR = 1,03 [1,01-1,05]). Las readmisiones y las estancias post-UCI no diferían significativamente entre las altas no programadas y las normales (el 7,3 frente al 8,2%; p = 0,68 y 16, 7 ± 16,7 frente a 18,7 ± 21,3 días, respectivamente; p = 0,162). Conclusiones: Las altas no programadas son frecuentes en nuestro medio y contribuyen significativamente a la mortalidad post-UCI, sin que parezcan afectar a otros resultados de la asistencia a pacientes críticos. Impact of the premature discharge on hospital mortality after a stay in an intensive care unit Abstract Objective: To determine the frequency and to evaluate the relationship between premature discharge and post-ICU hospital mortality. Design: A prospective registry was made for patients admitted during six consecutive years, performing a retrospective analysis of the data on the first admission of ICU survivors. Setting: A 10-bed general ICU in a 540-bed tertiary-care community hospital. Patients: 1,521 patients with an ICU stay longer than 12 hours, discharged alive to wards with known hospital outcome. Interventions: None. Main variables:We recorded the patient data, including types of ICU discharge, normal or premature, and studying their relationship with post-ICU hospital mortality. The types of ICU discharge were also evaluated versus ICU readmission rate and post-ICU length of stay. Results: There were 165 patients (10.8%) with premature discharge. Mortality rate was 11.6% (176 patients). The factors related with mortality were withdrawal and limitation of life-sustaining treatments (OR=14. 02 [4.6-42.6 Conclusions: Premature discharges appear to be common in our setting and have a significant impact on mortality. Types of ICU discharge do not seem to be related with other outcome variables in the hospital care of cr...

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Ward mortality after ICU discharge: a multicenter validation of the Sabadell score

Abstract: We confirm the ability of the Sabadell score at ICU discharge to define four groups of patients with very different likelihoods of hospital survival.

Cited by 58 publications

References 14 publications

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Clinical outcomes of patients admitted in intensive care units of Nigist Eleni Mohammed Memorial Hospital of Hosanna, Southern Ethiopia

Intensive care performance: How should we monitor performance in the future?

Impacto de las altas no programadas en la mortalidad hospitalaria tras la estancia en una unidad de cuidados intensivos

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