Risk factors for predicting mortality in a surgical intensive care unit in the year 2000.

OBJECTIVE: To determine the mortality and risk factors of mortality in a surgical intensive care unit (SICU), King Chulalongkorn Memorial Hospital. DESIGN: Review of retrospective data. SETTING: a SICU of a tertiary-care academic medical center. PATIENTS: Out of a total of 546 patients admitted to SICU during a one year period (January 1, 2000 - December 31, 2000), 458 (83.9%) had complete medical data which were analyzed. MEASUREMENTS AND MAIN RESULTS: One hundred and ninety-three variables of 6 categories of patients' characteristics, chronic disease, acute illness, physiologic variables, therapy and miscellaneous were studied. Univariate and multivariate analyses were used. The SICU and hospital mortality was 8.1 and 14.6 per cent, respectively. Multivariate logistic regression analysis identified seven variables as independent risk factors for mortality (p < 0.05): chronic renal failure (adjusted odds ratio [AOR], 7.5; 95% CI, 3.0 to 19.0; p = 0.000), coma (AOR, 11.7; 95% CI, 2.4 to 57.4; p = 0.002), Staphylococcus aureus infection (AOR, 15.4; 95% CI, 1.6 to 147.6; p = 0.018), diagnosis of systemic inflammatory response (AOR, 2.9; 95% CI, 1.2 to 7.1; p = 0.017), mechanical ventilation (AOR, 11.2; 95% CI, 2.0 to 61.4; p = 0.005), having received adrenaline (AOR, 7.1; 95% CI, 2.3 to 22.2; p = 0.001) and diuretic (AOR, 3.3; 95% CI, 1.4 to 8.1; p = 0.008). Besides weight (AOR, 0.9; 95% CI, 0.9 to 1.0; p = 0.002) and having received H2-blocker (AOR, 0.2; 95% CI, 0.1 to 0.5; p = 0.001) were two independent protective factors for mortality. CONCLUSION: Knowing the risk factors of SICU mortality will help physicians to improve patient care, educate patients and their families, optimize ICU resource planning and may decrease health care costs.

Parental presence during induction of anesthesia in children: a study on parental attitudes and children's cooperation.

Parental attitudes and children's cooperation towards parental presence during induction of anesthesia (PPIA) were studied in one hundred parents and one hundred children aged 1-10 years. The dimensions of parental attitudes were how much PPIA is beneficial or harmful to their child, whether their presence could help the anesthetist, whether the parents should be present and their feelings during induction of anesthesia. Before and after induction of anesthesia respectively, 83 per cent and 87 per cent of the parents thought their presence was mostly beneficial to their child, 77 per cent and 83 per cent thought their presence was least harmful, 64 per cent and 71 per cent believed their presence could help the anesthetist and 97 per cent of the parents agreed that parents should be present during induction of anaesthesia. From the children, perspective, 86 per cent of the children cooperated with induction. It was concluded that PPIA was well accepted by the parents and the majority of the children were cooperative.