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Mortalidad y ajuste por riesgo en la Unidad de Cuidados Intensivos del Hospital Clinicoquirúrgico "Hermanos Ameijeiras"

Keywords: mortality, quality, intensive care unit.

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Abstract:

introduction: mortality is the main indicator of results of care quality in intensive care units (icus). despite to be care units for severe patients, where inevitably they dye, care received by these patients is directed to avoid death. objective: to develop a function of the variables allowing the appropriate estimation of the probability of dye. methods: a cohort and retrospective study was conducted in the intensive care unit of the "hermanos ameijeiras" clinical surgical hospital of la habana, from january, 2002 to june, 2004. sample including 537 medical records with complete data was randomized divided in two groups, of 269 and 268 medical records, respectively. in the first group authors estimated la ecuación de regresión logística, the dependent variable was the mortality and the independent variables: apache ii value, age, sex, and surgical status and in the second one, the diagnosis. in the second part of sample for validation, it was assessed the discrimination by means of the roc curve and the calibration using the hosmer and lemeshow test. results: the distribution of all variables was similar in both groups, only the sex distribution showed significant differences among them. the variables index of severity apache ii, diagnosis and type of patient (surgical or not) determine the mortality in the icu according to the expected in hypothesis. conclusions: it was possible to model the probability of dye in such a way that the model may be used in other patients to estimate the potential number of deaths in a determined period obtaining a powerful tool to look for and to detect the problems of care quality.

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