| |
All
|
January 2006 to October 2007
|
November 2007 to November 2009
|
December 2009 to May 2011
|
June 2011 to May 2013
|
June 2013 to December 2014
|
|
Type of disinfectant dressing added to the ongoing catheter bundle*
| |
None
|
CHG sponge on CVC only
|
CHG sponge on all catheters
|
Replacement of CHG sponge by CHG gel in 2 out of 5 ICUs
|
CHG gel on all catheters (five of five ICUs)
|
|
ICU activity
|
|
ICU treatment days
|
91,292
|
17,185
|
20,429
|
15,476
|
20,726
|
17,476
|
|
Mean ICU LOS, days (SD)
|
5.0 (15.6)
|
4.3 (7.5)
|
4.4 (7.9)
|
5.1 (9.2)
|
5.3 (11.6)
|
6.3 (17.3)
|
|
Admissions (all ICU stays), n
|
19,423
|
4213
|
4931
|
3213
|
4133
|
2933
|
|
Emergency (%)
|
13,651 (70.3)
|
3037 (72.1)
|
3484 (71.5)
|
2183 (70.1)
|
2872 (71.3)
|
2075 (70.7)
|
|
Surgical admissions, n (%)
|
13,018 (67.0)
|
2779 (66.0)
|
3258 (66.1)
|
2265 (70.5)
|
2749 (66.5)
|
1967 (67.1)
|
|
Scheduled surgery, n (%)
|
5722 (29.5)
|
1222 (29.0)
|
1409 (28.6)
|
963 (30.0)
|
1211 (29.3)
|
917 (31.3)
|
|
Emergency surgery, n (%)
|
7296 (37.5)
|
1557 (37.0)
|
1849 (37.5)
|
1302 (40.5)
|
1538 (37.2)
|
1050 (35.8)
|
|
Site of surgery
|
|
Cardiovascular, n (%)
|
2131 (16.4)
|
436 (15.7)
|
536 (16.5)
|
343 (15.1)
|
452 (16.4)
|
364 (18.5)
|
|
Digestive, n (%)
|
1621 (12.5)
|
296 (10.7)
|
432 (13.3)
|
268 (11.8)
|
356 (13.0)
|
269 (13.7)
|
|
Neurosurgery, n (%)
|
1173 (9.0)
|
300 (10.8)
|
313 (9.6)
|
203 (9.0)
|
204 (7.4)
|
153 (7.8)
|
|
Thoracic, n (%)
|
663 (5.1)
|
138 (5.0)
|
163 (5.0)
|
106 (4.7)
|
132 (4.8)
|
124 (6.3)
|
|
Trauma, n (%)
|
795 (5.9)
|
174 (6.3)
|
194 (6.0)
|
137 (6.1)
|
145 (5.3)
|
145 (7.4)
|
|
Workload: NEMS mean (SD) per 12 h shift
|
30 (25–37)
|
28 (27–32)
|
31 (27–37)
|
31 (27–37)
|
30 (25–37)
|
29 (22–36)
|
|
ICU treatments
|
|
Patients with ventilation, admissions (%)
|
7146 (36.8)
|
1306 (30.1)
|
1533 (31.1)
|
1216 (37.9)
|
1492 (36.1)
|
1599 (54.5)
|
|
Ventilation-days
|
50,852
|
8008
|
10,901
|
9445
|
12,574
|
9924
|
|
Mechanical ventilation, mean days/months (SD)
|
471 (108)
|
364 (76)
|
436 (80)
|
525 (77)
|
524 (116)
|
522 (79)
|
|
Catheter-days
|
155,242
|
27,713
|
34,363
|
26,128
|
36,689
|
30,349
|
|
CVC (%)
|
89,489 (57.6)
|
15,547 (56.1)
|
19,553 (56.9)
|
15,024 (57.5)
|
21,641 (59.0)
|
17,724 (58.4)
|
|
CVC-jugular (%)
|
41,684 (46.6)
|
6618 (42.6)
|
8365 (42.8)
|
7128 (47.4)
|
10,642 (49.2)
|
8931 (50.4)
|
|
CVC-sub-clavian (%)
|
16,747 (18.7)
|
3549 (22.8)
|
3740 (19.1)
|
3070 (20.4)
|
3866 (17.9)
|
2521 (14.2)
|
|
CVC-femoral (%)
|
31,058 (34.7)
|
5380 (34.6)
|
7448 (38.1)
|
4826 (32.1)
|
7132 (33.0)
|
6272 (35.4)
|
|
Arterial (%)
|
65,753 (42.3)
|
12,166 (43.9)
|
14,810 (43.1)
|
11,104 (42.5)
|
15,048 (41.0)
|
12,625 (41.6)
|
|
Catheter-days per month, mean (SD)
|
1419 (275)
|
1161 (189)
|
1322 (191)
|
1471 (169)
|
1545 (295)
|
1636 (232)
|
|
Patient with extra-renal replacement therapy, admissions, (%)
|
1621 (8.4)
|
204 (4.8)
|
352 (7.1)
|
250 (7.8)
|
424 (10.3)
|
391 (13.3)
|
|
Mean extra-renal replacement therapy, mean hours/month (SD)
|
1370 (847)
|
763 (460)
|
1162 (717)
|
1037 (437)
|
1824 (883)
|
2091 (843)
|
|
Patients
|
|
Number
|
18,286
|
3981
|
4607
|
3022
|
3901
|
2775
|
|
Age, year (median, IQR)
|
63.7 (51.4–73.9)
|
62.6 (50.3–73.2)
|
63.6 (50.8–74.4)
|
65.0 (54.3–74.5)
|
64.3 (52.3–74.6)
|
65.2 (52.6–74.5)
|
|
Males, n (%)
|
12,025 (65.8)
|
2632 (66.1)
|
3040 (66.0)
|
1995 (66.0)
|
2536 (65.0)
|
1822 (65.7)
|
|
Patient comorbidities
|
|
NYHA IV (%)
|
1864 (10.2)
|
396 (9.9)
|
554 (12.0)
|
348 (11.5)
|
335 (8.6)
|
231 (8.3)
|
|
Chronic dialysis, n (%)
|
396 (2.2)
|
80 (2.0)
|
114 (2.5)
|
49 (1.6)
|
67 (1.7)
|
86 (3.1)
|
|
Severe COPD, n (%)
|
1383 (7.6)
|
309 (7.8)
|
312 (6.8)
|
215 (7.1)
|
288 (7.4)
|
259 (9.3)
|
|
Liver cirrhosis, n (%)
|
739 (4.0)
|
128 (3.2)
|
171 (3.7)
|
121 (4.0)
|
182 (4.7)
|
137 (4.9)
|
|
Metastatic cancer, n (%)
|
2356 (12.9)
|
461 (11.6)
|
581 (12.6)
|
375 (12.4)
|
541 (13.9)
|
398 (14.3)
|
|
Mc Cabe—within 5 years, n (%)
|
5088 (27.8)
|
1078 (27.1)
|
1342 (29.1)
|
824 (27.3)
|
1021 (26.2)
|
823 (29.7)
|
|
Mc Cabe—within 1 year, n (%)
|
1741 (9.5)
|
290 (7.3)
|
415 (9.0)
|
265 (8.8)
|
458 (11.7)
|
313 (11.3)
|
|
Major critical illness
|
|
Hemorrhagic shock, n (%)
|
657 (3.6)
|
130 (3.3)
|
100 (2.2)
|
112 (3.7)
|
166 (4.3)
|
149 (5.4)
|
|
Cardiogenic shock, n (%)
|
726 (4.0)
|
166 (4.2)
|
157 (3.4)
|
126 (4.2)
|
136 (3.5)
|
141 (5.1)
|
|
Septic shock, n (%)
|
1299 (7.1)
|
207 (5.2)
|
326 (7.1)
|
180 (6.0)
|
331 (8.5)
|
255 (9.2)
|
|
Pneumonia, n (%)
|
2511 (13.7)
|
544 (13.7)
|
587 (12.7)
|
382 (12.6)
|
544 (13.9)
|
454 (16.4)
|
|
Peritonitis, n (%)
|
408 (2.2)
|
87 (2.2)
|
114 (2.5)
|
58 (1.9)
|
81 (2.1)
|
68 (2.5)
|
|
Severity
|
|
SAPS II median (IQR)
|
38 (27–49)
|
35 (25–45)
|
36 (26–47)
|
38 (29–49)
|
41 (30–53)
|
40 (28–51)
|
|
ICU mortality, n (%)
|
1974 (10.8)
|
386 (9.7)
|
441 (9.6)
|
305 (10.1)
|
474 (12.2)
|
368 (13.3)
|
|
Hospital post-ICU mortality, n (%)
|
539 (2.9)
|
115 (2.9)
|
157 (3.4)
|
100 (3.3)
|
99 (2.5)
|
68 (2.5)
|