Characteristics and outcomes of patients admitted to Spanish ICU: A prospective observational study from the ENVIN-HELICS registry (2006-2011)

Autores de IIS La Fe

• José Ricardo Gimeno Costa

  Autor

Participantes ajenos a IIS La Fe

• Olaechea, PM
• Alvarez-Lerma, F
• Palomar, M
• Gracia, MP
• Mas, N
• Rivas, R
• Seijas, I
• Nuvials, X
• Catalan, M
• ENVIN-HELICS Study Grp

Grupos

• Medicina Intensiva

  Leader

  Álvaro Castellanos Ortega

Abstract

Objective: To describe the case-mix of patients admitted to intensive care units (ICUs) in Spain during the period 2006-2011 and to assess changes in ICU mortality according to severity level. Design: Secondary analysis of data obtained from the ENVN-HELICS registry. Observational prospective study. Setting: Spanish ICU. Patients: Patients admitted for over 24 h. Interventions: None. Variables: Data for each of the participating hospitals and ICUs were recorded, as well as data that allowed to knowing the case-mix and the individual outcome of each patient. The study period-was divided into two intervals, from 2006 to 2008 (period 1) and from 2009 to 2011 (period 2). Multilevel-and multivariate models were used for the analysis of mortality and were performed. in each stratum of severity level. Results: The study population included 142,859 patients admitted to 188 adult ICUs. There was an increase in the mean age of the patients and in the percentage of patients >79 years (11.2% vs. 12.7%, P<0.001). Also, the mean APACHE II score increased from 14.35 +/- 8.29 to 14.72 +/- 8.43 (P < 0.001). The crude overall intra-UCI mortality remained unchanged (11.4%) but adjusted mortality rate in patients with APACHE II score between 11 and 25 decreased modestly in recent years (12.3% vs. 11.6%, odds ratio = 0.931, 95% CI 0.883-0.982; P=0.008). Conclusion: This study provides observational longitudinal data on case-mix of patients admitted to Spanish ICUs. A slight reduction in ICU mortality rate was observed among patients with intermediate severity level. (C) 2015 Elsevier Espana, S.L.U. and SEMICYUC. All rights reserved.

Keywords

• Case-mix; Critically ill patients; ENVIN-HELICS registry; Intensive care units; Mortality; Severity; Nosocomial infection; Epidemiological registry