Changes in intensive care from 1987 to 1997 - has outcome improved? A single centre study.
OBJECTIVE
To study changes in a single intensive care unit (ICU) over a 10 year period and to investigate possible concomitant changes in outcome.


METHODS
The ICU populations in 1987 and 1997 in a university hospital.


METHODS
Prospective and retrospective cohort study. The ICU database was used for comparison of the ICU populations, and SAPS II-estimated hospital survival was compared with observed survival. Three year follow-up survival (the Peoples Registry) was compared with population survival (Statistics Norway). In the year 2000 the Short Form 36 (SF 36) questionnaire was used for quality of life (QOL) measurement. Results were compared with a reference population.


METHODS
None.


RESULTS
From 1987 to 1997 the numbers of patients and stays increased from 219 and 236 to 338 and 370. ICU activity per stay increased considerably, but length of stay remained unchanged (6.0 versus 5.9 days). The 1997 ICU patients were, on average, older (50.3 versus 46.0 years) and more severely ill (SAPS II 42.7 versus 34.7). They had a higher crude mortality, but the time from admission to when the observed mortality reached the predicted mortality was longer, indicating an increased survival length. Two years after intensive care, there was no excess mortality compared with population survival in either cohort. QOL was significantly reduced in both cohorts compared to population scores.


CONCLUSIONS
This study indicates that the increased intensive care activity over the 10 year period was associated with a prolonged severity-adjusted survival. QOL was still reduced 3 and 13 years after ICU, compared to population scores.
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021 Bergen, Norway. reidar.kvaale@haukeland.no
Reidar
R
Kvåle
Hans
H
Flaatten
D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000592:standards / Q000639:trends*; D005260:Female; D006302:Health Services Research; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000639:trends*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009664:Norway; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D011788:Quality of Life; D016019:Survival Analysis; D016896:Treatment Outcome