[Predictive value of score parameters of the Simplified Acute Physiology Score (SAPS)-II for the duration of treatment of intensive care patients].
Length of intensive care therapy and the total length of stay in hospital are important determinants of hospital costs. We therefore analysed the correlation between score parameters of SAPS-II with the time spent in the intensive care unit (ICU), and also in the hospital, for 604 general medical intensive care patients (ICU group) and 510 coronary care patients (CCU group). The mean stay in the ICU was 3.68 days for ICU patients and 2.67 days for CCU patients. The total stay in hospital was 13.5 days vs 16.1 days with a mortality of 18% (risk of death 0.21) in ICU and 10% (risk of death 0.13) in CCU patients. In patients who died, duration of therapy in the ICU was significantly longer than in surviving patients (5.88 vs 3.20 days in the ICU group and 3.65 vs 2.56 days in the CCU group). In contrast, total hospital stay was significantly shorter in patients who died (8.6 vs 14.5 days in the ICU group and 8.8 vs 16.9 days in the CCU group) (p = 0.001). The risk of death calculated from SAPS II was significantly correlated with the duration of intensive care. There was a significant indirect correlation between risk of death and the total hospital stay. In ICU patients duration of intensive treatment and hospital stay correlated with age, heart rate, maximum systolic blood pressure, body temperature, BUN, serum bilirubin, and sodium (all signs of systemic inflammatory reaction and organ dysfunction); in CCU patients length of intensive treatment and hospital stay correlated with body temperature, diuresis, BUN, bicarbonate, minimum systolic blood pressure (as signs of organ perfusion). A low Glasgow Coma Score was correlated with prolonged intensive care in all patients. In conclusion, score data, appear a suitable tool to predict the duration of intensive care treatment and length of hospitalization, in addition to outcome, and thus serve as gauge of efficiency.
Schuster
H P
HP
Medizinische Klinik I, Städtisches Krankenhaus Hildesheim, Akademisches Lehrkrankenhaus, Bundesrepublik Deutschland.
Wilts
S
S
Ritschel
P
P
Schuster
F P
FP
D000368:Aged; D003325:Coronary Care Units / Q000191:economics; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015996:Survival Rate
Voraussagekraft von Scoreparametern des Simplified Acute Physiology Score (SAPS)-II für die Behandlungsdauer von Intensivpatienten.