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PubMed · 8353790

Using severity measures to describe high performance intensive care units.

D Teres·S Lemeshow
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Abstract

This article describes the use of various scores and probabilities to clinically categorize patients in the adult intensive care unit. Some of the limitations of these severity measures are reviewed including variable definitions, timing of measurements, and whether models can be used for individual patients. Also, this article discusses how probability models may be used to compare similar types of intensive care units using standardized clinical and cost performance indices.

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Hospital MortalityHumansInpatientsIntensive Care UnitsPatient AdmissionPatient DischargeQuality Assurance, Health CareSeverity of Illness IndexTriageJournal ArticleResearch Support, Non-U.S. Gov'tReview

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D Teres, S Lemeshow. 1993. Using severity measures to describe high performance intensive care units.. https://pubmed.ncbi.nlm.nih.gov/8353790/

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Impact of simple interventions on neonatal mortality in a low-resource teaching hospital in India.

OBJECTIVE: To evaluate impact of simple interventions on neonatal mortality in a low-resource teaching hospital in India. STUDY DESIGN: Before-and-after intervention trial setting: limited resource teaching hospital; DESIGN: Before and after study. INTERVENTIONS: A package of simple interventions was evolved. The interventions included: rational admissions and early discharge, entrusting mothers in care-giving, enforcing asepsis routines, aggressive enteral feeding, abandoning unnecessary interventions, protocol-based management, rational antibiotics and training and empowerment of nurses. STATISTICAL METHODS: The categorical and continuous variables were compared with chi (2) and two-tailed tests, respectively. RESULTS: Neonatal mortality rate declined significantly during the intervention period as compared to control period (20.3 versus 29.3 per 1000 live births; relative risk 0.69, 95% confidence interval (CI) 0.57 to 0.85). Most significant decline occurred in sepsis-related deaths. The survival of neonates with birth weight 1000 to 1499 improved over two folds (56.7% versus 24.5%, P<0.01). There was a significant decline in antibiotics use (635/878, 72.3% versus 299/897, 23.2%; P=0.00). The duration of stay in neonatal unit was decreased by a mean of 1.5 day (95% CI 0.9 to 2.8 days) after interventions. CONCLUSIONS: Simple interventions can result in a significant decline in neonatal mortality in hospitals with limited resources. This package is likely to be effective in hospitals with a high proportion of the sepsis deaths.

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