Tuberc Respir Dis.
2012 Aug;73(2):100-106.
The Impact of Implementing Critical Care Team on Open General Intensive Care Unit
- Affiliations
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- 1Department of Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea.
- 2Department of Surgery, Kangwon University School of Medicine, Chuncheon, Korea.
- 3Department of Pediatrics, Konkuk University School of Medicine, Chungju, Korea.
- 4Department of Neurology, Konkuk University School of Medicine, Chungju, Korea.
- 5Department of Gastroenterology, Konkuk University School of Medicine, Chungju, Korea.
- 6Department of Pulmonary and Critical Care Medicine, Konkuk University School of Medicine, Chungju, Korea. medicor@kku.ac.kr
Abstract
- BACKGROUND
There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes.
METHODS
We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation.
RESULTS
We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05).
CONCLUSION
Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.
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