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Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry

INTRODUCTION: Mortality in Polish intensive care units (ICU) is excessively high. Only a few patients do not require intubation and invasive ventilation throughout the whole ICU treatment period. We aimed to define this population, as pre-emptive admissions of such patients may increase the populati...

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Autores principales: Knapik, Piotr, Knapik, Małgorzata, Trejnowska, Ewa, Kłaczek, Bogumiła, Śmietanka, Konstanty, Cieśla, Daniel, Krzych, Łukasz J., Kucewicz, Ewa M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764313/
https://www.ncbi.nlm.nih.gov/pubmed/31572479
http://dx.doi.org/10.5114/aoms.2019.84401
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author Knapik, Piotr
Knapik, Małgorzata
Trejnowska, Ewa
Kłaczek, Bogumiła
Śmietanka, Konstanty
Cieśla, Daniel
Krzych, Łukasz J.
Kucewicz, Ewa M.
author_facet Knapik, Piotr
Knapik, Małgorzata
Trejnowska, Ewa
Kłaczek, Bogumiła
Śmietanka, Konstanty
Cieśla, Daniel
Krzych, Łukasz J.
Kucewicz, Ewa M.
author_sort Knapik, Piotr
collection PubMed
description INTRODUCTION: Mortality in Polish intensive care units (ICU) is excessively high. Only a few patients do not require intubation and invasive ventilation throughout the whole ICU treatment period. We aimed to define this population, as pre-emptive admissions of such patients may increase the population which benefits from ICU admission and reduce excessive mortality in Polish ICUs. MATERIAL AND METHODS: Data on 20 651 patients from the Silesian Registry of Intensive Care Units were analysed. Patients who did not require intubation and invasive ventilation (referred to as non-ventilated patients) were identified and compared to the remaining ICU population. Independent variables that influence being non-intubated in the ICU were identified. RESULTS: Among 20 368 analyzed adult patients, only 1233 (6.1%) were in the non-ventilated group. Non-ventilated patients were younger, with fewer comorbidities and a lower APACHE II score at admission (13.0 ±7.1 vs. 23.7 ±8.6 points, p < 0.001). Patients with cardiac arrest prior to admission were particularly rare in this group (2.6% vs. 26.8%, p < 0.001). The ICU mortality among non-ventilated patients was 6 to 7 times lower (7.0% vs. 46.7%, p < 0.001). Independent variables that influenced the ICU stay in non-ventilated patients were: obstetric complications as the primary cause of ICU admission, presence of a systemic autoimmune disease, invasive monitoring as the primary cause of ICU admission, ICU readmission and the presence of cancer. CONCLUSIONS: Non-ventilated patients have a high potential for a favourable outcome. Pre‑emptive ICU admissions have a potential to reduce mortality in Polish ICUs.
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spelling pubmed-67643132019-09-30 Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry Knapik, Piotr Knapik, Małgorzata Trejnowska, Ewa Kłaczek, Bogumiła Śmietanka, Konstanty Cieśla, Daniel Krzych, Łukasz J. Kucewicz, Ewa M. Arch Med Sci Public Health INTRODUCTION: Mortality in Polish intensive care units (ICU) is excessively high. Only a few patients do not require intubation and invasive ventilation throughout the whole ICU treatment period. We aimed to define this population, as pre-emptive admissions of such patients may increase the population which benefits from ICU admission and reduce excessive mortality in Polish ICUs. MATERIAL AND METHODS: Data on 20 651 patients from the Silesian Registry of Intensive Care Units were analysed. Patients who did not require intubation and invasive ventilation (referred to as non-ventilated patients) were identified and compared to the remaining ICU population. Independent variables that influence being non-intubated in the ICU were identified. RESULTS: Among 20 368 analyzed adult patients, only 1233 (6.1%) were in the non-ventilated group. Non-ventilated patients were younger, with fewer comorbidities and a lower APACHE II score at admission (13.0 ±7.1 vs. 23.7 ±8.6 points, p < 0.001). Patients with cardiac arrest prior to admission were particularly rare in this group (2.6% vs. 26.8%, p < 0.001). The ICU mortality among non-ventilated patients was 6 to 7 times lower (7.0% vs. 46.7%, p < 0.001). Independent variables that influenced the ICU stay in non-ventilated patients were: obstetric complications as the primary cause of ICU admission, presence of a systemic autoimmune disease, invasive monitoring as the primary cause of ICU admission, ICU readmission and the presence of cancer. CONCLUSIONS: Non-ventilated patients have a high potential for a favourable outcome. Pre‑emptive ICU admissions have a potential to reduce mortality in Polish ICUs. Termedia Publishing House 2019-05-08 2019-09 /pmc/articles/PMC6764313/ /pubmed/31572479 http://dx.doi.org/10.5114/aoms.2019.84401 Text en Copyright: © 2019 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Public Health
Knapik, Piotr
Knapik, Małgorzata
Trejnowska, Ewa
Kłaczek, Bogumiła
Śmietanka, Konstanty
Cieśla, Daniel
Krzych, Łukasz J.
Kucewicz, Ewa M.
Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title_full Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title_fullStr Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title_full_unstemmed Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title_short Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry
title_sort should we admit more patients not requiring invasive ventilation to reduce excess mortality in polish intensive care units? data from the silesian icu registry
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764313/
https://www.ncbi.nlm.nih.gov/pubmed/31572479
http://dx.doi.org/10.5114/aoms.2019.84401
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