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Characterizing the Risk Profiles of Intensive Care Units

dc.contributor.authorMoreno, R
dc.contributor.authorHochrieser, H
dc.contributor.authorMetnitz, B
dc.contributor.authorBauer, P
dc.contributor.authorMetnitz, P
dc.date.accessioned2013-08-06T16:49:55Z
dc.date.available2013-08-06T16:49:55Z
dc.date.issued2010
dc.description.abstractOBJECTIVE: To develop a new method to evaluate the performance of individual ICUs through the calculation and visualisation of risk profiles. METHODS: The study included 102,561 patients consecutively admitted to 77 ICUs in Austria. We customized the function which predicts hospital mortality (using SAPS II) for each ICU. We then compared the risks of hospital mortality resulting from this function with the risks which would be obtained using the original function. The derived risk ratio was then plotted together with point-wise confidence intervals in order to visualise the individual risk profile of each ICU over the whole spectrum of expected hospital mortality. MAIN MEASUREMENTS AND RESULTS: We calculated risk profiles for all ICUs in the ASDI data set according to the proposed method. We show examples how the clinical performance of ICUs may depend on the severity of illness of their patients. Both the distribution of the Hosmer-Lemeshow goodness-of-fit test statistics and the histogram of the corresponding P values demonstrated a good fit of the individual risk models. CONCLUSIONS: Our risk profile model makes it possible to evaluate ICUs on the basis of the specific risk for patients to die compared to a reference sample over the whole spectrum of hospital mortality. Thus, ICUs at different levels of severity of illness can be directly compared, giving a clear advantage over the use of the conventional single point estimate of the overall observed-to-expected mortality ratio.por
dc.identifier.citationIntensive Care Med. 2010 Jul;36(7):1207-12.por
dc.identifier.urihttp://hdl.handle.net/10400.17/1431
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherSpringerpor
dc.subjectAPACHEpor
dc.subjectIntervalos de Confiançapor
dc.subjectMortalidade Hospitalarpor
dc.subjectUnidades de Cuidados Intensivospor
dc.subjectGarantia de Qualidade nos Cuidados de Saúdepor
dc.subjectAvaliação de Riscopor
dc.subjectÍndice de Gravidade da Doençapor
dc.titleCharacterizing the Risk Profiles of Intensive Care Unitspor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1212por
oaire.citation.startPage1207por
oaire.citation.titleIntensive Care Medicinepor
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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