• Fabiane Urizzi, Marcos T Tanita, Josiane Festti, Cardoso Lucienne T Q LTQ Departamento de Medicina Interna, Hospital Universitario, Universidade Estadual de Londrina, Londrina, PR, BR., Tiemi Matsuo, and Grion Cintia M C CMC Departamento de Medicina Interna, Hospital Universitario, Universidade Estadual de Londrina, Londrina, PR, BR..
• Pos-graduacao, Hospital Universitario, Universidade Estadual de Londrina, Londrina, PR, BR.
• Clinics (Sao Paulo). 2017 Oct 1; 72 (9): 568-574.

ObjectivesThis 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.MethodsA 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.ResultsFour 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.ConclusionsPatients 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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