Articles: intensive-care-units.
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The Journal of pediatrics · Jan 1996
Multicenter StudyVariability in duration of stay in pediatric intensive care units: a multiinstitutional study.
Development of a statistical model to predict length of stay (LOS) in a pediatric intensive care unit (PICU) that adjusts for patient-related risk factors at admission. ⋯ The predictor can be used to adjust LOS in PICUs for patient-related risk factors, enabling the comparison of resource utilization among different institutions. Organizational factors known to foster team-oriented care are associated with shorter LOS, whereas increased relative PICU size may pose an incentive to keep PICU beds occupied longer.
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Critical care medicine · Jan 1996
Multicenter StudySimplified Therapeutic Intervention Scoring System: the TISS-28 items--results from a multicenter study.
To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. ⋯ The simplified TISS-28 explains 86% of the variation in TISS-76 and can therefore replace the original version in the clinical practice in the ICU. Per shift, a typical nurse is capable of delivering nursing activities equal to 46 TISS-28 points.
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Clinical Trial
PRISM score evaluation to predict outcome in pediatric patients on admission at an emergency department.
This study was undertaken in order to evaluate for the first time the usefulness of PRISM score to predict outcome in pediatric patients in the Intensive Care Area of the Emergency Department at the Instituto Nacional de Pediatría in Mexico City. A prolective evaluation of PRISM score was done using 100 consecutive pediatric patients admitted to INP-ED between July and November 1992 and considered critically ill by the attending pediatricians to calculate by a lineal logistic model the expected mortality and compare with the observed one. Using a cut-off of r = 0, we evaluated at the same time the sensitivity, specificity and efficiency of this score. ⋯ The sensitivity, specificity and efficiency in general were 1.0, 0.98 and 0.98, respectively. The PRISM is an objective and efficient method which helps physicians to predict patients' outcome and risk of mortality, providing the medical staff with an epidemiological criteria. Additionally, it may be helpful in decision-making for ICU admissions and correct identification of patients who can benefit from that level of care.
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To develop a method based on admission day data for predicting patient outcome status as independently functional, compromised functional, or dead. ⋯ Prediction of three outcome states using physiologic status, baseline functional level, and broad-based diagnostic groupings at admission is feasible and may improve the relevance of quality of care assessment.
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Critical care medicine · Jan 1996
Frequency of variable measurement in 16 pediatric intensive care units: influence on accuracy and potential for bias in severity of illness assessment.
We evaluated: a) whether the frequency of variable measurement could influence the performance of the Pediatric Risk of Mortality (PRISM) score; b) whether measurement frequency of physiologic variables varied between individual pediatric intensive care units (ICUs), and c) if so, how much of this variability could be attributed to institution-level and patient-level factors. ⋯ Although measurement frequency is associated with unit-level factors, their contribution to the overall variability is small and unlikely to influence the accuracy or reliability of the PRISM score. It is unlikely that there are routine biases associated with differences in measurement frequency of PRISM variables within the spectrum of care practices that now exist.