Objectives: To evaluate clinical practice in our intensive care unit over a period of 3 consecutive years (January 1991-December 1993).
Patients and methods: Retrospective computer analysis of clinical data recorded for the 1157 patients admitted during the study period.
Results: Seven hundred thirteen men and 443 women were admitted. Mean age was 58.8 years. Eighty-nine percent had undergone elective or emergency surgery, 7% were non surgical emergency admissions and 4% were transferred from other hospital wards. The mean stay was 3.8 days, though the mean stay for elective surgery patients was significantly shorter (p < 0.001). We assess the usefulness of the APACHE-II scale applied during the first 24 hours of admission, finding that mean scores were significantly lower (p < 0.001) for the 1089 survivors (10.2 +/- 4.7) than for the 68 patients who died (23.6 +/- 9.4). The score on the APACHE II scale was above 16 for 82% of those who died. Overall mortality for the unit was 5.9%, though the proportion was statistically higher (p < 0.001) in emergency patients. Complications developed in 299, though the number of complications was significantly lower (p < 0.001) for elective surgery patients. The patients who died required more use of invasive monitoring and mechanical ventilation (p < 0.001).
Conclusions: Our review shows that mortality, lengthy of stay in the unit and number of complications were all greater among emergency admissions. The patients who died had higher mean APACHE-II scores and required more care. Computerized data collection and later analysis is a useful way to assess clinical practice and facilitate future studies.