Comparative assessment of pediatric intensive care in Moscow, the Russian Federation
1996; Lippincott Williams & Wilkins; Volume: 24; Issue: 8 Linguagem: Inglês
10.1097/00003246-199608000-00021
ISSN1530-0293
AutoresJoseph DiCarlo, Tatyana A. Zaitseva, Tatyana V. Khodateleva, Irina D. Belayeva, Dmitrii A. Stroganov, Lev M. Korobko, Alexander V. Lee, Boris Mescheryakov, John S. Sullivan, Vladimir F. Alies,
Tópico(s)Respiratory Support and Mechanisms
ResumoObjective Comparative assessment of pediatric intensive care. Design Prospective multicenter study. Setting Four pediatric intensive care units in Moscow, the Russian Federation. Patients Consecutive unselected admissions (n = 583), 1% or the administration of intensive care unit-dependent therapies. In all four hospitals, observed mortality rates were higher than expected, with a range of standardized mortality ratios between 1.10 and 1.83 (mean 1.32). The excess mortality was found in the low- and medium-risk strata (risk of mortality of <1% to 15%). Admission efficiency ratings did not fluctuate greatly between institutions (mean 60.4%, range 55.7 to 65.9). Conclusions We provided a quantitative description and assessment of pediatric intensive care in Moscow. Moderate efficiency may reflect a low threshold for ICU admission due to poor nurse/patient ratios on the wards. Effectiveness in the low- and medium-risk strata is below standard, as compared with a Western reference population. Excess mortality was concentrated in the low- and medium-risk strata, and can only partially be explained by the inclusion of co-morbidity. Future analysis should focus on specific treatment protocols, protocol adherence, and the determination of infectious and therapeutic complications. (Crit Care Med 1996; 24:1403-1407)
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