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Author Zimmerman, Jack E. ♦ Kramer, Andrew A.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Management & auxiliary services ♦ General management ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Diagnosis ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Services Administration ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Intensive Care Units ♦ Patient Admission ♦ Patient Care Management ♦ Aged ♦ Diagnosis, Differential ♦ Humans ♦ Logistic Models ♦ Middle Aged ♦ Risk Assessment ♦ Journal Article ♦ Research Support, Non-u.s. Gov't ♦ Validation Studies
Abstract PURPOSE: This study presents a new model for identifying patients who might be too well to benefit from intensive care unit (ICU) care. PATIENTS AND METHODS: Intensive care unit admissions in 2002 to 2003 were used to develop a model to predict whether patients monitored on day one would receive one or more of 33 subsequent active life-supporting treatments. Accuracy was assessed by testing the model in a subsequent cohort of admissions in 2004 to 2006. We then assessed the frequency of active treatment among monitor patients at a low (<10%) risk for active life-supporting therapy on ICU day 1. RESULTS: Among 28 847 ICU monitor admissions in 2004 to 2006, 3153 patients (11.0%) were predicted to receive active treatment; 3296 (11.5%) actually did. There were 17 720 admissions with a low (<10%) risk for receiving subsequent active life-supporting treatment; 1238 (7.0%) received subsequent active treatment. Hospital mortality (2.5%) and mean ICU stay (1.8 days) suggests that most of these patients did not require ICU care. CONCLUSIONS: The outcome for low-risk monitor patients suggest they may be too well to benefit from intensive care. The frequency of low-risk monitor admissions provides a measure of ICU resource use. Improved resource use and reduced costs might be achieved by strategies to provide care for these patients on floors or intermediate care units.
Description Country affiliation: United States
Author Affiliation: Zimmerman JE ( The Department of Anesthesia and Critical Care Medicine, George Washington University, Washington, DC, USA.)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2010-06-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 25
Issue Number 2


Source: WHO-Global Index Medicus