Articles: intensive-care-units.
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To determine whether insurance status (managed care vs traditional commercial and Medicare) influences resource consumption (as measured by length of stay [LOS]) in the intensive care unit (ICU). ⋯ Though patients covered under managed care consume fewer ICU resources, this appears to be primarily attributable to a difference in patient-related factors. Thus, as managed care case mix changes in the future to include sicker and older patients, the initial advantages of reduced resource consumption may diminish.
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Intensive care medicine · Oct 1996
The influence of length of stay in the ICU on power of discrimination of a multipurpose severity score (SAPS). ARCHIDIA.
To assess how the power of discrimination of a multipurpose severity score (Simplified Acute Physiology Score; SAPS) changes in relation to the length of stay (LOS) in the intensive care unit (ICU). ⋯ The logistic model that we developed meets high standards for discrimination and calibration. However, SAPS loses its discriminative power over time; accuracy of prediction is maintained at an acceptable level only in patients who stay in the ICU no longer than 5 days. The stay in the ICU represents a complex variable, which is not predictable, that influences the performance of SAPS on the first day.
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Intensive care medicine · Oct 1996
Limitation of life support: frequency and practice in a London and a Cape Town intensive care unit.
To examine the frequency of limiting (withdrawing and withholding) therapy in the intensive care unit (ICU), the grounds for limiting therapy, the people involved in the decisions, the way the decisions are implemented and the patient outcome. ⋯ Withdrawal of therapy occurred commonly, most often because of multiple organ failure. Wide consensus was reached before a decision was made, and the time to death was generally short.
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To determine the diagnostic yield of routine admission chest radiographs in patients with acute gastrointestinal (GI) hemorrhage and clinical predictors of radiographic abnormalities. ⋯ These data indicate that routine chest radiographs have a low yield in detecting major new radiographic abnormalities in patients with acute GI hemorrhage. Clinical criteria, available at the time of admission, may be useful for selecting patients for chest radiographic evaluations.