Original Article
Evaluation of outcome and performance of an intensive care unit in Hong Kong by APACHE IV model: 2007–2014
Abstract
Background: Intensive care unit (ICU) consumes large amount of resources to manage critically ill patients. It is important to evaluate the outcome and performance of ICU service for optimization of resource allocation.
Methods: We analysed the demographic data and outcomes of patients admitted to our ICU between 1 January, 2007 and 31 December 2014.
Results: Totally 8,037 records were analysed. The annual admission was around 1,000. The mean age of the patients ranged from 57.87 to 59.98 years old and there was male predominance. Almost half of the admissions were non-operative cases. For the post-operative admissions, about half of them had emergency surgeries and the other had elective surgeries. The mean Acute Physiology and Chronic Health Evaluation (APACHE) IV acute physiological score (APS) ranged from 57.78 to 64.01. The overall readmission rate was 4–5% and about 1.5% of patients were readmitted within 72 hours. The mean length of stay (LOS) was around 5 days and the median LOS was about 2.5 days. The ICU mortality rate was approximately 10% and the hospital mortality rate was approximately 20% respectively. After risk adjustment, the standardized mortality ratio (SMR) was about 0.8 and the LOS ratio was about 1.
Conclusions: The case-mix of the patients in our ICU was comparable from 2007 to 2014. During the study period, there was no wide fluctuation of the ICU outcome and performance in terms of SMR and LOS ratio.
Methods: We analysed the demographic data and outcomes of patients admitted to our ICU between 1 January, 2007 and 31 December 2014.
Results: Totally 8,037 records were analysed. The annual admission was around 1,000. The mean age of the patients ranged from 57.87 to 59.98 years old and there was male predominance. Almost half of the admissions were non-operative cases. For the post-operative admissions, about half of them had emergency surgeries and the other had elective surgeries. The mean Acute Physiology and Chronic Health Evaluation (APACHE) IV acute physiological score (APS) ranged from 57.78 to 64.01. The overall readmission rate was 4–5% and about 1.5% of patients were readmitted within 72 hours. The mean length of stay (LOS) was around 5 days and the median LOS was about 2.5 days. The ICU mortality rate was approximately 10% and the hospital mortality rate was approximately 20% respectively. After risk adjustment, the standardized mortality ratio (SMR) was about 0.8 and the LOS ratio was about 1.
Conclusions: The case-mix of the patients in our ICU was comparable from 2007 to 2014. During the study period, there was no wide fluctuation of the ICU outcome and performance in terms of SMR and LOS ratio.
