P to optimise ICU admission and discharge processes and thus boost resource utilisation amongst ICU,

P to optimise ICU admission and discharge processes and thus boost resource utilisation amongst ICU, intermediate care unit, and ward in the future.Supplies and techniques: We prospectively evaluated all sufferers admitted to the essential care unit (CCU) of our 200-bed tertiary care hospital, from July of 1999 to August of 2000. Sufferers younger than 16 years of age and those whose admission towards the CCU was shorter than 24 hours, had been excluded. Clinical data collected integrated: age, sex, admitting diagnosis, length of stay, physiological variables and Glasgow coma scale. Laboratory information incorporated: WBC, BUN, creatinine, total bilirrubin, prothrombin time, serum sodium and potassium and arterial pO2. We also documented want for mechanical ventilation, FIO2, and final outcome at time of discharge (dead or alive). The chi-square test was made use of for qualitative variables, and ANOVA was utilized for continuous variables. A P < 0.05 was assigned statistical significance. Results were expressed as percentages, confidence intervals (CI 95 ), means and standard deviations (SD). We analysed the observed mortality vs predicted mortality ratio (OM/PM), sensitivity, specificity and percentage of accurate prediction for a cut off point of 50 of probability of death. TheSCritical CareVol 5 Suppl21st International Symposium on Intensive Care and Emergency MedicineReceptor Operator Curve (ROC) was used to determine the LOD's power of discrimination. The `Goodness of Fit' test (Hosmer emeshow) was applied to evaluate the calibration in our population. Results: 448 patients were included in the study. Thirty percent of patients who met LOD criteria developed severe multiple organ failure (MOF). The average LOD score was 1.83 ?2.26 with a predicted probability of death of 9.47 ?11.30 . The global mortality rate was 17.6 (80 patients); therefore the OM/PM ratio was1.85. The global percentage of accurate prediction was 85.71 for a cut off point of 50 of probability of death. The area under the ROC was 0.834 (CI 95 0.781?.886). The Hosmer?Lemeshhow test showed a GOF of 20.59. Conclusion: In our hands, the LOD system proved to be capable of discriminating among critically ill patients those likely to die. It, however, did not prove an appropriate calibation in our population of patients. We emphasize the need for proper regional validation in populations different from those in which the tools were developed.P225 Value of SOFA (Sequential Organ Failure Assessment) score and total maximum SOFA score in 812 patients with acutecardiovascular disordersU Janssens, R Dujardin, J Graf, W Lepper, J Ortlepp, M Merx, M Zarse, T Reffelmann, P Hanrath Medical Clinic I, RWTH Aachen, Pauwelsstr 30, 52057 Aachen, Germany Objectives: The SOFA score is composed of scores from six organ systems (respiratory [R], cardiovascular [C], hepatic [H], coagulation [Co], renal [Re], and neurological [N]) graded from 0 to 4 according to the degree of dysfunction/failure. The aggregate score (total maximum SOFA score [TMS]) is calculated summing the worst scores for each of the organ systems (TMSOrg) during the ICU stay. We investigated the outcome discrimination of the TMS and the association with ICU length of stay (ICU-LOS) in patients PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20718733 (pts) with acute cardiovascular disorders. Strategies: 812 consecutive pts (age 62 ?13 years, 69.7 male, SAPS II 29 ?14, 266 pts acute myocardial infarction, 161 pts unstable YL0919 chemical information angina, 96 pts rhythm disturbances, 63 pts heart failure, 47 pts cardiac arrest, 179 pts.