Details

Autor(en) / Beteiligte

• Divatia, Jigeeshu
• Amin, Pravin
• Ramakrishnan, Nagarajan
• Kapadia, Farhad
• Todi, Subhash
• Sahu, Samir
• Govil, Deepak
• Chawla, Rajesh
• Kulkarni, Atul
• Samavedam, Srinivas
• Jani, Charu
• Rungta, Narendra
• Samaddar, Devi
• Mehta, Sujata
• Venkataraman, Ramesh
• Hegde, Ashit
• Bande, B
• Dhanuka, Sanjay
• Singh, Virendra
• Tewari, Reshma
• Zirpe, Kapil
• Sathe, Prachee

Titel

Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study

Ist Teil von

• Indian journal of critical care medicine, 2016-04, Vol.20 (4), p.216-225

Ort / Verlag

India: Wolters Kluwer - Medknow Publications

Erscheinungsjahr

2016

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Aims: To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). Patients and Methods: An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. Results: On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. Conclusions: The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India.