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Consumption of Resources (CR) in Critically Ill Patients (CIP) With Percutaneous Tracheostomy (PT)
Intensive Care Medicine Experimental volume 3, Article number: A482 (2015)
Introduction
It is considered that the CR of CIPs requiring PT is higher than the overall CIP population. However, both the identification of specific ICU procedures and the relative weight (RW) of the diagnostic related groups (DRG) case - mix system related to each CIP have not been researched sufficiently.
Objectives
To identify and evaluate the CR of the CIPs with need of PT in comparison with the CIPs without requiring RRT.
To evaluate and compare the RW of the DRGs between CIPs with PT and without.
Methods
Exclusion criteria: CIPs < 16 years, major burn patients, incomplete clinical documentation, and voluntary discharge
Variables analyzed:
Study: prospective, analytical, longitudinal, and observational
Period: January 1-2011 / June 30-2014 (42 months)
Setting
Medical/Surgical ICU belonging to a 2790 acute care teaching hospital
Population: 2559 CIPs admitted consecutively to the ICU; sample: 53 CIPs
Exclusion criteria: CIPs < 16 years, major burn CIPs, incomplete clinical documentation, and voluntary discharge.
Variables analyzed:
a) length of stay (LOS), readmission
b) RW of DRG (AP-DRG 25.0 version)
c) invasive mechanical ventilation (IMV), non-invasive mechanical ventilation (nIMV)
d) renal replacement therapy (RRT)
e) Intracranial pressure, transcranial Doppler ultrasound
f) isolation measures
g) cardiac catheterization
Statistical analysis: Ji squared and contrast of means (Student's t)
Results
Conclusions
LOS and readmission are remarkably higher in the CIPs with PT
The RW of DRG is seven times higher in the CIPs with PT
Although expected, IMV and nIMV are also remarkably higher in the CIPs with PT
Isolation measures are more used in CIPs with PT (> 40 %)
RRT, ICP, TCDU and cardiac catheterization are more used in the CIPs with PT
Cardiac catheterization is more used in the CIPs without PT
References
Thomas AN, McGrath BA: Patient safety incidents associated with airway devices in critical care: a review of reports to the UK National Patient Safety Agency. Anaesthesia. 2009, 64 (4): 358-365. 10.1111/j.1365-2044.2008.05784.x.
Silvester W, Goldsmith D, Uchino S, Bellomo R, Knight S, Seevanayagam S, et al: Percutaneous versus surgical tracheostomy: a randomised controlled study with long term follow up. Crit Care Med. 2006, 34 (8): 2145-2152. 10.1097/01.CCM.0000229882.09677.FD.
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Ruiz Moreno, J., González Marín, E., Esteve Paños, M. et al. Consumption of Resources (CR) in Critically Ill Patients (CIP) With Percutaneous Tracheostomy (PT). ICMx 3 (Suppl 1), A482 (2015). https://doi.org/10.1186/2197-425X-3-S1-A482
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DOI: https://doi.org/10.1186/2197-425X-3-S1-A482