Clinical Outcome and Costs in Different Patient Population in Intensive Care: a Multicentre Study

Czech version

Authors: R. Pařízková; V. Černý; P. Dostál; L. Vašátko ¹; P. Hora ²; I. Herold ³; Novák I. Nalos D. ^{2 1}
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny LF UK a FN, Hradec Králové, přednosta doc. MUDr. Vladimír Černý, PhD., FCCM, 1 Anesteziologicko-resuscitační oddělení, Masarykova nemocnice, Ústí nad Labem, primář MUDr. Daniel Nalos, 2 I. interní
Published in: Anest. intenziv. Med., , 2001, č. 5, s. 234-239
Category:

Overview

Intensive care represents an especially costly part of health care, and significantly affects total cost of in-patient hospital facilities. The aim of thestudy was to compare the amount of costs and selected clinical markers in different diagnosis related groups, to compare results and to establish thecharacteristics of patient populations.In the set of 1,368 patients, we prospectively followed APACHE II and SOFA scores, length of hospitalization, clinical outcome and costs.The patients were divided according to the type of admission (primary, secondary within 24 hours and secondary after 24 hours) and according tothe principle diagnosis to the following groups: trauma (TR, n = 115), head-brain injury (KCP, n = 137), chronic obstructive pulmonary disease(COPD, n = 86), post-CPR states (KPCR, n = 184), acute respiratory distress syndrome (ARDS, n = 76) and intoxications (INTOX, n = 425). APACHEII and SOFA scores of the whole group were significantly higher in non-survivors compared to survivors (median, percentiles 25–75%): 31, 24–36and 13 (10–15) resp. 22, 16–28 and 7, 4–9; P < 0.001. Mean mortality of the group was 18,8%, the highest mortality was in the group KPCR (28,8%),the least in the group KCP (10,9%). The longest length of stay (median, percentiles 25–75%) was observed in ARDS patients (14, 8–21), the shortestin the patients of INTOX group (3, 2–7).The mean cost associated with one patient of the group was 205,309 CZK, median 79,346 (23,467–242,249); non-survivors showed a statisticallysignificant higher costs compared to survivors (median 92,929, percentiles 30,925–324,362 resp. 75,552; 21,649–233,583; P = 0.047). The costs ofthe whole group correlated with the length of hospitalization, R = 0,679 (P < 0,001). Comparing the costs between separate subgroups, the highestcosts were observed in patients with ARDS, the least costly were intoxicated patients. The leading factor determining the costs in all patients was thelength of stay.

Key words:
intensive care – APACHE II score – SOFA score – costs

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