Quality and reliability of data collected in a regional hospital intensive care unit.
OBJECTIVE
To examine the accuracy of the existing data collection system in an intensive care unit (ICU).


METHODS
Prospective audit of data collection for APACHE II in a six-bedded general ICU in a region-al hospital for consecutive ICU admissions over a 12 month period. The existing resident medical officer (RMO) data collection system continued unaltered while concurrent collection of APACHE II data completed by one senior medical officer (SMO) was also performed. RMO-APACHE scores were compared to SMO-APACHE scores.


RESULTS
The median (interquartile range) APACHE II scores were: 15 (9-21) for RMO data; 17 (12 - 22) for SMO data (p = 0.0001), with a mean difference (SD) of 4.2 (4.2) (p < 0.0001). A rapid survey of New Zealand ICU's indicated that only 4 of 11 APACHE II users employed substantial medical specialist involvement in APACHE II data collection and/or scrutiny prior to database entry.


CONCLUSIONS
The existing APACHE II data collection is often imperfect and requires further attention as it is not yet reliable enough to allow for accurate SMR calculations, or for external use for comparative purposes.
Intensive Care Unit, Palmerston North Hospital, Palmerston North, New Zealand. gerard.mchugh@midcentral.co.nz
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McHugh