title: [Comparative analysis of patients admitted to Spanish Intensive Care Units due to medical and surgical disease].
abstract: OBJECTIVE
  To describe the characteristics of the patients case-mix admitted to ICUs due to medical and surgical disease, and to compare both groups.
  
  
  METHODS
  Analysis of data covering the period 2006-2011 in the ENVIN-HELICS registry. An observational, prospective, multicenter and voluntary participation study.
  
  
  METHODS
  A total of 188 Spanish ICUs.
  
  
  METHODS
  All patients admitted for more than 24 hours.
  
  
  METHODS
  Demographic data, cause of admission, severity scores, length of stay, mortality.
  
  
  RESULTS
  A total of 138,999 patients were analyzed. Of these, 65,467 (47.1%) were admitted due to a non-coronary medical cause, 27,785 (20,0%) due to coronary-related illness, 28,044 (20,2%) after elective surgery and 17,613 (12.7%) after urgent surgery. Use of devices, nosocomial infections and isolation of multirresistant organisms were more prevalent in urgent surgery patients. Longer length of stay (median 5 days; interquartile range 2-11) as well as higher severity scale values (APACHE II and SAPS II) corresponded to this same group of patients. Mortality was higher in non-coronay medical patients. On categorizing the patients according to the APACHE II score, mortality was seen to be higher in urgent surgery cases than in elective surgery patients in all groups. The largest difference was observed in the APACHE II score 6-10 group (3% vs. 0.9%) (OR: 2.14, 95% CI 1.825-2.513; p<0.001).
  
  
  CONCLUSIONS
  The mortality rate is higher in non-coronary medical patients, though resource use per patient is greater in the urgent surgery cases. The APACHE II scale underestimates mortality in emergency surgery patients.
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España. Electronic address: NAIA.MASBILBAO@osakidetza.net.
authors.forename: N
authors.initials: N
authors.lastname: Mas
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España.
authors.forename: P
authors.initials: P
authors.lastname: Olaechea
authors.affiliation: Servicio de Medicina Intensiva, Hospital Arnau de Villanova, Lleida, España.
authors.forename: M
authors.initials: M
authors.lastname: Palomar
authors.affiliation: Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Alvarez-Lerma
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España.
authors.forename: R
authors.initials: R
authors.lastname: Rivas
authors.affiliation: Servicio de Medicina Intensiva, Hospital Arnau de Villanova, Lleida, España.
authors.forename: X
authors.initials: X
authors.lastname: Nuvials
authors.affiliation: Servicio de Medicina Intensiva, Hospital La Fe, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: Gimeno
authors.affiliation: Servicio de Medicina Intensiva, Hospital 12 de Octubre, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Catalán
authors.affiliation: Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España.
authors.forename: M P
authors.initials: MP
authors.lastname: Gracia
authors.affiliation: Servicio de Medicina Intensiva, Hospital Cruces, Barakaldo, Vizcaya, España.
authors.forename: I
authors.initials: I
authors.lastname: Seijas
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals / Q000145:classification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007388:Internal Medicine; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D013030:Spain / Q000453:epidemiology; D013514:Surgical Procedures, Operative; D055815:Young Adult
keywords: APACHE II; Case-mix; Cuidados intensivos; Elective surgery; Intensive care; Medical disease; Mortalidad; Mortality; Pacientes médicos; Quirúrgico programado; Quirúrgico urgente; Urgent surgery