The Impact of Implementing Critical Care Team on Open General Intensive Care Unit.
10.4046/trd.2012.73.2.100
- Author:
Ick Hee KIM
1
;
Seung Bae PARK
;
Seonguk KIM
;
Sang Don HAN
;
Seung Seok KI
;
Gyu Rak CHON
Author Information
1. Department of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
- Publication Type:Original Article
- Keywords:
Critical Care;
Intensive Care Units;
Mortality
- MeSH:
APACHE;
Budgets;
Critical Care;
Humans;
Critical Care;
Intensive Care Units;
Logistic Models;
Prospective Studies;
Respiration, Artificial;
Weaning
- From:Tuberculosis and Respiratory Diseases
2012;73(2):100-106
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. METHODS: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. RESULTS: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). CONCLUSION: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.
