The Evaluation of Factors Affecting on Patient Admission from Operating Room to Intensive Care Unit in University Teaching Hospital
Introduction:By consideration of clinical predictors and true way for transfer of patient from the operating room (OR), it can be prevented of complications and be reduced mortality rate.Thus, the study aimed to investigate clinical predictors of admitted cases from OR to ICU.
Method:In this study250 patients were transferred to ICU.data such as underlying diseases, prior reservation for transferring to ICU, unexpected decision for transferring, problems in OR, multi-trauma, and other effective causes of transferring were analyzed.
Results:Of 250 subjects, 144(57.6%) were male.The four major causes of admission to ICU follow as trauma(43.6%), respiratory problems(20.4%), bleeding (19.6%)and postoperative care (16.4%). The most common causes in traumatic patients included brain trauma (60 cases), multiple trauma (32 cases), and abdominal trauma (8 cases).
Conclusion:The viewpoint of an anesthesiologist for selection of patient who requires to receiving critical care services is also necessary.
J. P. Sculier, M. Paesmans, E. Markiewicz and T. Berghmans ,” Scoring systems in cancer patients admitted for an acute complication in a medical intensive care unit”, Critical care medicine, vol. 28, no. 8, pp. 2786-92, 2000.
S. C. Veltkamp, J. M. Kemmeren, Y. Van der Graaf, M. Edlinger and C. van der Werken, “ Prediction of serious complications in patients admitted to a surgical ward”, British Journal of surgery, vol. 89, no.1, pp. 94-102, 2002.
H. Menke, A. Klein, K. D. John and T. H. Junginger, “ Predictive value of ASA classification for the assessment of the perioperative risk”, International surgery, vol. 78, no. 3, pp. 266-70, 1992.
P. H. K. Mak, R. C. H. Campbell and M. G. Irwin, “The ASA physical status classification: Inter-observer consistency” Anesthesia and Intensive Care; vol. 30, no. 5, pp. 633, 2002.
Jones JS, Dwyer PR, White LJ, Firman R. Patient transfer from nursing home to emergency department: outcomes and policy implications. Academic Emergency Medicine. 1997;4(9):908-15.
Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, et al. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Critical care medicine. 1999;27(9):1991-8.
Morales IJ, Peters SG, Afessa B. (2003). Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit*. Critical care medicine, 31(3), 858-63.
Tibby SM, Taylor D, Festa M, Hanna S, Hatherill M, Jones G, et al. (2002). A comparison of three scoring systems for mortality risk among retrieved intensive care patients. Archives of disease in childhood, 87(5), 421-5.
Marcin JP, Slonim AD, Pollack MM, Ruttimann UE. (2001). Long-stay patients in the pediatric intensive care unit. Critical care medicine, 29(3), 652-7.
Goldhill DR, McNarry AF, Hadjianastassiou VG, Tekkis PP. (2004 Oct). The longer patients are in hospital before Intensive Care admission the higher their mortality. Intensive Care Med, 30(10), 1908-13.
Young MP, Gooder VJ, McBride K, James B, Fisher ES. (2003 Feb). Inpatient transfers to the intensive care unit: delays are associated with increased mortality and morbidity. J Gen Intern Med, 18(2), 77-83.
Combes A, Luyt CE, Trouillet JL, Chastre J, Gibert C. (2005 Apr). Adverse effect on a referral intensive care unit's performance of accepting patients transferred from another intensive care unit. Crit Care Med, 33(4), 705-10.
Laver S, Farrow C, Turner D, Nolan J. (2004 Nov). Mode of death after admission to an intensive care unit following cardiac arrest. Intensive Care Med, 30(11), 2126-8.
Finkielman JD, Morales l, Peters SG, Keegan MT, Ensminger SA, Lymp JF, et al. (2004 May). Mortality rate and length of stay of patients admitted to the intensive care unit in July. Crit Care Med, 32(5), 1161-5.
Chiavone PA, Sens YAdS. (2003). Evaluation of APACHE II system among intensive care patients at a teaching hospital. Sao Paulo Medical Journal, 121(2), 53-7.