[An index of daily intensive care unit activity].
OBJECTIVE
To set up an index for the evaluation of type of interventions and procedures applied a prerequisite for the evaluation of appropriateness of ICU's activity.


METHODS
Observation prospective study.


METHODS
2507 patients out of the 5030 enrolled in the cohort study.


METHODS
A cross-sectional assessment of the volume and intensity of treatment--level of care--delivered to patients was performed at a preidentified index day. A check list of procedures was utilized. Intensive high level treatment was demonstrated by the application of procedures suggesting one or more organs or vital functions intensively supported. Sub-intensive treatment was defined by the application of procedures indicating monitoring or treatments not exclusively performed in intensive environment.


RESULTS
3955 samples were collected over 9 index days; 2707 (68.3%) resulted in intensive, 1227 (30.7%) subintensive or intermediate and 41 (1%) ward treatments. Out of the intensive samples, 63.4% received only one intensive procedure, while 27.9% two. Ventilatory support was the most frequently (90.4%) utilized intensive procedure. Overall 99% of the samples were characterized by treatments/procedures too invasive for normal ward.


CONCLUSIONS
The proposed method gives the opportunity to easily evaluate the level of care and then the appropriateness of ICU care.
Rotelli
S
S
Servizio di Anestesia e Rianimazione, IRCCS Ospedale Maggiore, Milano.
Iapichino
G
G
Colombo
A
A
Apolone
G
G
Brazzi
L
L
Calappi
E
E
Leonetti
C
C
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged