Articles: intensive-care-units.
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Am. Rev. Respir. Dis. · Aug 1989
Multicenter Study Clinical TrialPrognosis with mechanical ventilation: the influence of disease, severity of disease, age, and chronic health status on survival from an acute illness.
This report presents a model for relating readily available clinical and physiologic measurements to prognosis from mechanical ventilation. Using data from 571 acutely ill, ventilated patients admitted to the intensive care units of 12 hospitals, it illustrates the relationship between the disease, the initiating respiratory failure, the acute severity of the disease, and the patient's age and chronic health status and the patient's probability of survival. ⋯ After 3 days of ICU treatment, estimates for hospital mortality increased to 97% (39 patients). We believe that such estimates, when available from a larger number of patients and combined with additional information on the patient's desires, expectations, preillness quality of life, and prognosis for long-term survival, can be helpful in decisions to withhold and withdraw mechanical ventilation.
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Intensive care medicine · Jan 1989
Multicenter Study Clinical TrialDescription of various types of intensive and intermediate care units in France. French Multicentric Group of ICU Research.
The types of intensive care are multiple. The aim of this multicentric study was to describe activity of different ICUs using the same methods. 38 ICU were chosen by cooption, not randomization. Collected data concerned input (age, previous health status (HS), Simplified Acute Physiology Score or SAPS, Intensive Care Group (ICG), processes (TISS points), percentage of ventilated patients and pulmonary arterial lines and outcome (ICU death rate). ⋯ Surgical patients had better previous health status, were younger and scheduled for 40%. TISS points were higher, mainly by a higher rate of ventilated patients and patients with pulmonary artery lines on the first day. Specialized units characteristics depended mainly on the ICG.(ABSTRACT TRUNCATED AT 250 WORDS)
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Critical care medicine · Nov 1988
Multicenter Study Clinical TrialPediatric risk of mortality (PRISM) score.
The Pediatric Risk of Mortality (PRISM) score was developed from the Physiologic Stability Index (PSI) to reduce the number of physiologic variables required for pediatric ICU (PICU) mortality risk assessment and to obtain an objective weighting of the remaining variables. Univariate and multivariate statistical techniques were applied to admission day PSI data (1,415 patients, 116 deaths) from four PICUs. ⋯ In all groups, the number and distribution of survivors and nonsurvivors in adjacent mortality risk intervals were accurately predicted: total validation group (chi 2(5) = 0.80; p greater than .95), each PICU separately (chi 2(5) range 0.83 to 7.38; all p greater than .10), operative patients (chi 2(5) = 2.03; p greater than .75), nonoperative patients (chi 2(5) = 2.80, p greater than .50), cardiovascular disease patients (chi 2(5) = 4.72; p greater than .25), respiratory disease patients (chi 2(5) = 5.82; p greater than .25), and neurologic disease patients (chi 2(5) = 7.15; p greater than .10). ROC analysis also demonstrated excellent predictor performance (area index = 0.92 +/- 0.02).