[Mortality surveillance in an intensive care unit].
BACKGROUND
Annual reports from Norwegian Intensive Care Units include risk-adjusted mortality data. Annual variation may be difficult to interpret due to random variation and changes in case mix. Several methods have been developed for continuous monitoring of treatment results in clinical practices where it is possible to calculate a risk for a certain outcome, usually risk of death. We have used the cumulative risk adjusted mortality chart Variable Life Adjusted Display (VLAD) to further illustrate our treatment results.


METHODS
3190 patients were treated in our intensive care unit during the period 1997-2006. 2777 of these patients were given scores for risk of death during hospitalization and the treatment result (as risk-adjusted mortality) was calculated.


RESULTS
The risk-adjusted mortality varied from year to year with a tendency for better survival the last years. Variation in mortality was clearly demonstrated by the Variable Life Adjusted Display (VLAD) curve.


CONCLUSIONS
The VLAD curve is a very useful supplement to traditional methods of evaluating the performance of intensive care units. The method is useful for showing how treatment results vary over time.
Haagensen
Rolf
R
Anestesiavdelingen Akershus, universitetssykehus, 1478 Lørenskog. haarol@online.no
Smith-Erichsen
Nils
N
D003422:Critical Care / Q000592:standards; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D009664:Norway / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D020379:Risk Adjustment; D016019:Survival Analysis; D015996:Survival Rate