Articles: intensive-care-units.
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To develop a predictive index for length of stay in the intensive care unit (ICU) following cardiac surgery. ⋯ Length of ICU stay and death following cardiac surgery can be predicted with a multivariate predictive index. The index has potential application as a means of stratifying cardiac surgical risk as well as in optimizing ICU resource planning when resources are limited.
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The objective of our study was to evaluate the applicability of the Acute Physiology and Chronic Health Evaluation (Apache II) scoring system in an Israeli general intensive care unit (GICU), and to monitor the outcome of care using the Apache II severity score. We compared over a 3-year period the distribution of Apache II score, and of hospital mortality in our GICU (790 consecutive admissions) to that of the original American study, using a prediction formula based on 5,815 admissions in the United States. Our admissions were classified as post-elective surgery, post-emergency surgery or nonsurgical. ⋯ The majority of excess mortality occurred in the nonsurgical group (odds ratio 1.27, 95% CI 1.09, 1.48). We found the Apache II score useful for determining the severity of illness in our GICU. The Apache equation accurately predicts the mortality of elective and emergency surgery admissions, but underestimates the mortality of nonsurgical admissions.
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Infect Control Hosp Epidemiol · Jul 1994
Comparative StudyViewpoint: survival benefit by selective decontamination of the digestive tract (SDD).
Morbidity and mortality due to infection acquired either before or after admission to the intensive care unit is still a major problem. A limited range of potentially pathogenic microorganisms (PPM) are involved, and infection with these PPM usually follows a predictable pattern. Selective decontamination of the digestive tract (SDD) should be investigated further in patients with primarily curable diseases who are not infected on admission to intensive care but become infected there.