Patient Characteristics and ICU Organizational Factors That Influence Frequency of Pulmonary Artery Catheterization

Article Abstract:

Specific factors appear to be responsible for the use of the pulmonary artery catheter. This catheter is inserted into the pulmonary arteries to monitor cardiopulmonary function in critically ill patients. In a study of 10,217 patients who received treatment at 34 medical, mixed medical and surgical, and surgical intensive care units (ICUs) at 27 hospitals, 8% received a pulmonary artery catheter. White patients were more likely to receive the catheter, as were patients with private insurance and those in a surgical ICU. ICUs with full-time doctors on staff were less likely to use the catheter.

Care and treatment, Research, Management, Arterial catheterization, Intensive care units

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Customized probability models for early severe sepsis in adult intensive care patients

Article Abstract:

Customized versions of statistical models appear to accurately estimate the probability of death in intensive care unit (ICU) patients with early severe sepsis. Researchers evaluated 11,458 patients in 12 countries for sepsis within 24 hours of their ICU admission. The patients' actual death rate was compared with the probability of death calculated by two customized statistical models: the Simplified Acute Physiology Score II (SAPS II) and the 24-hour Mortality Probability Model II (MPM II). A total of 1,130 patients fulfilled the criteria for severe sepsis. The death rate was 48% in severe sepsis patients and 19.6% in the other patients. The survival rate 28 days after ICU admission was lower in severe sepsis patients than in the other patients. Both the customized SAPS II and the customized MPM II accurately reflected patients' probability of death and accurately distinguished the patients who died from the patients who survived.

Evaluation, Prognosis, Mathematical models, Bacterial infections

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The Logistic Organ Dysfunction System: a new way to assess organ dysfunction in the intensive care unit

Article Abstract:

The Logistic Organ Dysfunction (LOD) score may predict which patients in an intensive care unit (ICU) have a high risk of dying. Researchers analyzed physiologic data from 10,547 ICU patients to create the LOD System and verified the results in 2,605 additional ICU patients. The LOD System assigns a score for 6 organ systems depending on the severity of signs and symptoms. However, the neurologic, cardiovascular and renal systems are weighted more heavily than the pulmonary, hematologic and hepatic systems. Probability of mortality ranged from 3.2% in those with a LOD score of zero to 99.7% in those with a maximum score of 22.

Methods, Patient outcomes, Mortality, Critical care medicine

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