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Consumption of Resources (CR) in Critically Ill Patients (CIP) With Percutaneous Tracheostomy (PT)

  • J Ruiz Moreno
  • E González Marín
  • MJ Esteve Paños
  • R Corcuera Romero de la Devesa
  • S Godayol Arias
  • MJ Riba Ribalta
  • N Conesa Folch
  • F Baigorri González
  • A Artigas Raventós
Open Access
Poster presentation
  • 130 Downloads

Keywords

Teaching Hospital Renal Replacement Therapy Intracranial Pressure Doppler Ultrasound Relative Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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
Table 1

Results I

 

Global

% or SD

PT

% or SD

no PT

% or SD

p value

CIPs

2559

100

53

2.1

2506

97.9

 

Age

65.9

16.7

70.6

10.5

65.7

16.8

0.0005

Mortality

182

7.1

25

47.2

157

6.2

0.0001

LOS

3.51

6.5

34.9

19.0

2.85

3.8

0.0005

Readmission

136

5.3

8

15.1

128

5.1

0.0013

RW od DRG

4.2137

5

30.4955

15.3

3.6579

2.3

0.001

Table 2

Results II

 

Global

% or SD

PT

% or SD

No PT

% or SD

p value

IMV

774

30.2

53

100

721

28.8

0.001

nIMV

298

11.6

31

58.5

267

10.6

0.001

RRT

91

3.6

12

22.6

79

3.1

0.001

ICP

14

0.5

3

5.7

11

0.4

0.001

TCDU

20

0.8

5

7.5

16

0.6

0.001

Isolation

92

3.6

23

43.4

69

2.7

0.001

Catheterization

103

4.0

0

0

103

4.1

0.001

References

  1. 1.
    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.PubMedCrossRefGoogle Scholar
  2. 2.
    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.PubMedCrossRefGoogle Scholar

Copyright information

© Ruiz Moreno et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • J Ruiz Moreno
    • 1
  • E González Marín
    • 1
  • MJ Esteve Paños
    • 1
  • R Corcuera Romero de la Devesa
    • 1
  • S Godayol Arias
    • 2
  • MJ Riba Ribalta
    • 1
  • N Conesa Folch
    • 1
  • F Baigorri González
    • 1
  • A Artigas Raventós
    • 3
  1. 1.Quirón Salud Hospital Universitario Sagrat Cor, Critical Care DepartmentBarcelonaSpain
  2. 2.Quirón Salud Hospital Universitario Sagrat Cor, Emergency DepartmentBarcelonaSpain
  3. 3.Hospital de Clínicas de Sabadell & Quirón Salud Hospital Universitario Sagrat Cor, Critical Care DepartmentSabadellSpain

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