• Medicina intensiva · Jan 2013

    Comparative Study

    Impact of a new model of intensive care medicine upon healthcare in a department of intensive care medicine.

    • B Suberviola, A González-Castro, F Ortiz-Melon, M S Holanda, M J Dominguez, C Blanco-Huelga, and C Muñoz.
    • Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España. jandro120475@hotmail.com
    • Med Intensiva. 2013 Jan 1;37(1):27-32.

    ObjectivesTo evaluate a new organizational model in an intensive care unit, with the implementation of early warning systems and a support unit.DesignA retrospective, comparative cohort study was carried out.SettingThe study was carried out in the Department of Intensive Care Medicine (DICM) of a tertiary hospital (2009-2011), with the comparison of three time periods (P1, P2 and P3) that differed in terms of organization and logistics.PatientsWe analyzed all patients admitted to the ICU during the study period. Patients from maternal and infant intensive care were excluded.Variables Of InterestPercentage of patients with stays of under two days, with invasiveness used; readmission to the DICM, type of admission and percentage of stays of longer than one month; APACHE II score, mean stay in the ICU and shift distribution of the admissions.ResultsWe analyzed a sample of 3209 patients (65% males), with a mean age of 58.23 (18.23) years, a mean APACHE II score of 16.67 (8.23), and presenting an occupancy rate of 7.3 (10.3) days in the analyzed period. The ratio APACHE II score/number of beds was 0.69 (0.34) in P1, compared to 0.68 (0.33) in P2 and 0.76 (0.37) in P3 (p<0.001). The intervention surveillance grade (grade 1) was 42% (39-46%) in P1, 40% (37-43%) in P2 and 31% (28-35%) in P3 (p<0.001). The average stay in the ICU ranged from 7.10 days (8.82) in P1 to 6.60 days (9.49) in P2 and 8.42 days (12.73) in P3 (p<0.001).ConclusionsThere has been an increase in the number of patients seen in our DICM, with a decrease in the patients admitted to the conventional ICU. Patients now admitted to the ICU are more seriously ill, require a greater level of intervention, and give rise to an increase in the mean duration of stay in the ICU.Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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