Caring for critically ill patients outside intensive care units due to full units: a cohort study
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/140035 |
Resumo: | OBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included. The data collected included clinical data, calculation of costs, prognostic scores, and outcomes. The patients were followed for data collection until intensive care unit admission or cancellation of the request for the intensive care unit bed. Vital status at hospital discharge was noted, and patients were classified as survivors or non-survivors considering this endpoint. RESULTS: Four hundred and fifty-four patients were analyzed. Patients were predominantly male (54.6%), and the median age was 62 (interquartile range (ITQ): 47 - 73) years. The median APACHE II score was 22.5 (ITQ: 16 - 29). Invasive mechanical ventilation was used in 298 patients (65.6%), and vasoactive drugs were used in 44.9% of patients. The median time of follow-up was 3 days (ITQ: 2 - 6); after this time, 204 patients were admitted to the intensive care unit and 250 had the intensive care unit bed request canceled. The median total cost per patient was US$ 5,945.98. CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment. |
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Clinics |
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Caring for critically ill patients outside intensive care units due to full units: a cohort studyIntensive Care UnitsBed OccupancyHealth Services AccessibilityDirect Service CostsCosts and Cost AnalysisOBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included. The data collected included clinical data, calculation of costs, prognostic scores, and outcomes. The patients were followed for data collection until intensive care unit admission or cancellation of the request for the intensive care unit bed. Vital status at hospital discharge was noted, and patients were classified as survivors or non-survivors considering this endpoint. RESULTS: Four hundred and fifty-four patients were analyzed. Patients were predominantly male (54.6%), and the median age was 62 (interquartile range (ITQ): 47 - 73) years. The median APACHE II score was 22.5 (ITQ: 16 - 29). Invasive mechanical ventilation was used in 298 patients (65.6%), and vasoactive drugs were used in 44.9% of patients. The median time of follow-up was 3 days (ITQ: 2 - 6); after this time, 204 patients were admitted to the intensive care unit and 250 had the intensive care unit bed request canceled. The median total cost per patient was US$ 5,945.98. CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2017-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/14003510.6061/clinics/2017(09)08Clinics; Vol. 72 No. 9 (2017); 568-574Clinics; v. 72 n. 9 (2017); 568-574Clinics; Vol. 72 Núm. 9 (2017); 568-5741980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/140035/135235Copyright (c) 2017 Clinicsinfo:eu-repo/semantics/openAccessUrizzi, FabianeTanita, Marcos T.Festti, JosianeCardoso, Lucienne T.Q.Matsuo, TiemiGrion, Cintia M.C.2017-10-25T11:34:41Zoai:revistas.usp.br:article/140035Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2017-10-25T11:34:41Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
title |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
spellingShingle |
Caring for critically ill patients outside intensive care units due to full units: a cohort study Urizzi, Fabiane Intensive Care Units Bed Occupancy Health Services Accessibility Direct Service Costs Costs and Cost Analysis |
title_short |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
title_full |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
title_fullStr |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
title_full_unstemmed |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
title_sort |
Caring for critically ill patients outside intensive care units due to full units: a cohort study |
author |
Urizzi, Fabiane |
author_facet |
Urizzi, Fabiane Tanita, Marcos T. Festti, Josiane Cardoso, Lucienne T.Q. Matsuo, Tiemi Grion, Cintia M.C. |
author_role |
author |
author2 |
Tanita, Marcos T. Festti, Josiane Cardoso, Lucienne T.Q. Matsuo, Tiemi Grion, Cintia M.C. |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Urizzi, Fabiane Tanita, Marcos T. Festti, Josiane Cardoso, Lucienne T.Q. Matsuo, Tiemi Grion, Cintia M.C. |
dc.subject.por.fl_str_mv |
Intensive Care Units Bed Occupancy Health Services Accessibility Direct Service Costs Costs and Cost Analysis |
topic |
Intensive Care Units Bed Occupancy Health Services Accessibility Direct Service Costs Costs and Cost Analysis |
description |
OBJECTIVES: This study sought to analyze the clinical and epidemiologic characteristics of critically ill patients who were denied intensive care unit admission due to the unavailability of beds and to estimate the direct costs of treatment. METHODS: A prospective cohort study was performed with critically ill patients treated in a university hospital. All consecutive patients denied intensive care unit beds due to a full unit from February 2012 to February 2013 were included. The data collected included clinical data, calculation of costs, prognostic scores, and outcomes. The patients were followed for data collection until intensive care unit admission or cancellation of the request for the intensive care unit bed. Vital status at hospital discharge was noted, and patients were classified as survivors or non-survivors considering this endpoint. RESULTS: Four hundred and fifty-four patients were analyzed. Patients were predominantly male (54.6%), and the median age was 62 (interquartile range (ITQ): 47 - 73) years. The median APACHE II score was 22.5 (ITQ: 16 - 29). Invasive mechanical ventilation was used in 298 patients (65.6%), and vasoactive drugs were used in 44.9% of patients. The median time of follow-up was 3 days (ITQ: 2 - 6); after this time, 204 patients were admitted to the intensive care unit and 250 had the intensive care unit bed request canceled. The median total cost per patient was US$ 5,945.98. CONCLUSIONS: Patients presented a high severity in terms of disease scores, had multiple organ dysfunction and needed multiple invasive therapeutic interventions. The study patients received intensive care with specialized consultation during their stay in the hospital wards and presented high costs of treatment. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/140035 10.6061/clinics/2017(09)08 |
url |
https://www.revistas.usp.br/clinics/article/view/140035 |
identifier_str_mv |
10.6061/clinics/2017(09)08 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/140035/135235 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 72 No. 9 (2017); 568-574 Clinics; v. 72 n. 9 (2017); 568-574 Clinics; Vol. 72 Núm. 9 (2017); 568-574 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222763249565696 |