title: A one-year mortality study of the most acutely ill patients in a medical-surgical intensive care unit: toward developing a model for selection of recipients of intensive care.
abstract: This study over a 1-year period of time in a medical-surgical ICU in a large metropolitan teaching hospital was conducted to determine the mortality rate among a select group of acutely ill patients. By operational definition the acutely ill patients included in this study were those who were admitted to the medical-surgical ICU and treated with at least two out of three of the following: MA-1 ventilator, flow-directed balloon-tipped catheter, and vasopressor(s). Of 158 patients in the study, 117 died during hospitalization. The personnel in this oversubscribed unit were constantly faced with the decision of who should and who should not be admitted and who should be transferred out. Statistics on intensive care management are converted into daily costs for intensive care for those who did and did not survive. Model building is discussed as a process necessary in determining who shall receive intensive care and who shall not. The basic premise for conducting the study was that decisions regarding who shall receive care that is expensive and in limited supply should be based on facts to the extent that they can be elucidated.
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling; D003365:Costs and Cost Analysis; D005260:Female; D006325:Heart Atria; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012121:Respiration, Artificial / Q000379:methods; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents