title: Prospective assessment of standardized mortality ratio (SMR) as a measure of quality of care in intensive care unit--a single-centre study.
abstract: BACKGROUND
  The standardized mortality ratio (SMR) is a recognized indicator of critical care quality. This ratio is used to compare actual hospital mortality of all patients treated in a Intensive Care Unit (ICU) with predicted mortality. The aim of the study was prospective analysis of SMR as a measure of quality of care in single ICU.
  
  
  METHODS
  Prospective study was performed during the period of 12 months in ICU of Czerniakowski Hospital in Warsaw. Predicted hospital mortality was calculated using the SAPS 3 model. The value of SMR was evaluated in the three risk groups (low, moderate, high risk) and included patients surgical status (nonoperative, after elective and emergency surgery).
  
  
  RESULTS
  A total of 341 patients were included. SMR in general population was 0,98 (95% CI 0,74-1,28). In the low and high-risk groups the value of SMR did not differ significantly from 1. In the average risk group as well as patients undergoing elective surgery, the value of SMR tended to exceed 1.
  
  
  CONCLUSIONS
  In groups of patients with low and high risk the values of SMR indicated favourable quality of care. Study results should prompt to carry out detailed analysis of the course of treatment of patients at average risk of death. Analysis of the course of treatment and qualification criteria for surgery in patients undergoing elective surgery is also indicated.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Czerniakowski Hospital, Warsaw, Poland. tomasz.siegel@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Siegel
authors.forename: Jan
authors.initials: J
authors.lastname: Adamski
authors.forename: Piotr
authors.initials: P
authors.lastname: Nowakowski
authors.forename: Dariusz
authors.initials: D
authors.lastname: Onichimowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Weigl
mesh_terms: D000368:Aged; D000465:Algorithms; D003422:Critical Care / Q000592:standards*; D017558:Elective Surgical Procedures; D004632:Emergency Medical Services / Q000592:standards; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D015233:Models, Statistical; D011044:Poland; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D018570:Risk Assessment; D013514:Surgical Procedures, Operative
keywords: intensive care; mortality; quality; standardized mortality ratio