[Surgical and trauma patients in a medical intensive care unit].
OBJECTIVE
to characterize and to assess in terms of severity the surgical and trauma patients admitted to a medical intensive care unit (ICU).


METHODS
retrospective study base on clinical records and the ICU computerized database.


METHODS
the medical ICU of a tertiary hospital.


RESULTS
of the 2468 patients admitted to the ICU in 1989, 289 (11.7%) were surgical or trauma ones. The more frequent reasons for admission were: the need for mechanical ventilation, metabolic problems, and depression of consciousness. Of these 289 patients, 48.1% required mechanical ventilation, 14.9 hemodialysis; 4.8% had a pulmonary artery catheter inserted. Mean APACHE II, TISS and MOF scores were high (20.09 +/- 9.29, 24.17 +/- 11.45 and 5.4 +/- 3.59); they were determined in 79.2, 88.2 and 43.9% of patients respectively. Both APACHE and TISS scores were correlated with mortality. When compared with medical patients, surgical/trauma ones although younger (52.9 +/- 20.7 years versus 55.9 +/- 20.2, p = 0.00152), had a longer mean stay in the ICU (7.63 +/- 12.7 days v. 3.64 +/- 7.61, p = 0.0001), and a higher mortality (also in the ICU) (28.7 v. 16.7, p = 0.0005.


CONCLUSIONS
these are seriously ill patients, who are frequently referred to the ICU in late stages of clinical evolution. We propose they should be closely followed, from the earliest possible stage, by medical-surgical teams, in order to benefit from a multidisciplinary approach.
Moreno
R
R
Serviço 1, Hospital de Santo António dos Capuchos, Lisboa.
Estrada
H
H
De Jesus
M B
MB
Sá
J
J
Rodrigues
A R
AR
D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*
Doentes cirúrgicos e politraumatizados numa unidade de cuidados intensivos médica.