El coste del ingreso prolongado del paciente crítico / The cost of prolonged hospital stay of the critical patient

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Monitorización de la calidad en un servicio de medicina intensiva / Monitoring quality in an intensive medicine department

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Influencia de la edad en la duración de la estancia y en la mortalidad de los pacientes que permanecen de forma prolongada en una Unidad de Cuidados Intensivos / Influence of age in the duration of the stay and mortality of patients who remain in an Intensive Care Unit for a prolonged time

Fundamentos y objetivo: No se conoce cuál es el verdadero papel de la edad en el pronóstico de los pacientes ingresados en las Unidades de Cuidados Intensivos (UCI). En este trabajo se analiza la influencia de la edad en la duración de la estancia y en la mortalidad de los pacientes que permanecen de forma prolongada en una UCI. Pacientes y método: Estudio retrospectivo observacional, con pacientes ingresados ≥14 días en UCI. Se establecieron 3 grupos de edad: menores de 50, entre 50-70 y mayores de 70 años. Se estudió la influencia de diferentes factores en la relación existente entre estancia y edad; además se analizó la estancia y la supervivencia en las UCI, hospitalaria y al año en función de los grupos. Resultados: Se incluyeron 707 pacientes. No se encontraron diferencias significativas entre los 3 grupos en la estancia hospitalaria (p=0,183). El grupo de mayor edad, que presentaba una mayor gravedad al ingreso, fue el que se sometió a más traqueotomías (74,7%) y de depuración extrarrenal (HDF) (10,8%). Al analizar la influencia de factores tales como el APACHE II, la estancia pre-UCI, la procedencia, la traqueotomía o las HDF, no se encontró relación alguna entre la estancia y la edad del paciente. La supervivencia decrecía a medida que se incrementaba la edad. Conclusiones: No se hallaron diferencias en la estancia en función de la edad, aunque sí en la mortalidad (AU)

Backgrounds and objective: The true role of the age in the prognosis of patients admitted in the ICU is not known. This work analyzes the influence of age on the duration of the stay and mortality of patients who remain in an Intensive Care Unit (ICU) for a long period of time. Patients and method: A retrospective, observational study was performed with patients hospitalized ≥14 days in the ICU. Three age groups were established: <50, 50-70 and >70 years. The influence of different factors on the relationship existing between stay and age was studied. In addition, stay and survival in the ICU, hospital and at one year were analyzed based on the groups. Results: A total of 707 patients were included. Significant differences in hospital stay (P=0.183) were not found among the three groups. The older group, which showed greater severity on admission, was the group undergoing the most tracheostomies (74.7%) and extrarenal purification (HDF) (10.8%). When the influence of factors such as APACHE II, pre-ICU stay, origin, tracheostomy or hemodiafiltration (HDF) were analyzed, no relation was found between stay and age of patient. Survival decreased as age increased. Conclusions: No differences were found in stay based on age, although a difference was found in mortality (AU)

Pronóstico de los pacientes médicos según la duración de su estancia en la unidad de cuidados intensivos / Prognosis of clinical patients according to length of stay in the intensive care unit

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Influence of age in the duration of the stay and mortality of patients who remain in an Intensive Care Unit for a prolonged time.

BACKGROUNDS AND OBJECTIVE: The true role of the age in the prognosis of patients admitted in the ICU is not known. This work analyzes the influence of age on the duration of the stay and mortality of patients who remain in an Intensive Care Unit (ICU) for a long period of time. PATIENTS AND METHOD: A retrospective, observational study was performed with patients hospitalized ≥14 days in the ICU. Three age groups were established: <50, 50-70 and >70 years. The influence of different factors on the relationship existing between stay and age was studied. In addition, stay and survival in the ICU, hospital and at one year were analyzed based on the groups. RESULTS: A total of 707 patients were included. Significant differences in hospital stay (P=.183) were not found among the three groups. The older group, which showed greater severity on admission, was the group undergoing the most tracheostomies (74.7%) and extrarenal purification (HDF) (10.8%). When the influence of factors such as APACHE II, pre-ICU stay, origin, tracheostomy or hemodiafiltration (HDF) were analyzed, no relation was found between stay and age of patient. Survival decreased as age increased. CONCLUSIONS: No differences were found in stay based on age, although a difference was found in mortality.

Factores pronósticos en los pacientes con síndrome coronario agudo que ingresaron en una unidad de cuidados intensivos / Prognostic factors in patients with acute coronary syndrome admitted to an intensive care unit

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Atención de calidad en un servicio de medicina intensiva / Quality health care in an intensive care unit

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Nutrición de calidad para el enfermo crítico / Quality nutrition for the critically ill

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Gestión de la calidad en una unidad de cuidados intensivos: implementación de la norma ISO 9001:2008 / No disponible

Los sistemas de gestión de la calidad permiten priorizar acciones para que se pueda mantener la seguridad y la eficacia de las tecnologías sanitarias. En la Unidad de Cuidados Intensivos (UCI) de nuestro hospital se ha implementado un plan de gestión de la calidad, que ha obtenido el reconocimiento como «Servicio Certificado que gestiona sus actividades según la norma UNE-EN ISO 9001:2008». Con la aplicación del sistema de gestión de la calidad se logra detectar las necesidades que puede cubrir el servicio, esto con el fin de lograr la satisfacción del paciente, familiar o personal sanitario del resto de los servicios del hospital, mejorar las comunicaciones dentro y fuera del servicio, conseguir una mayor comprensión de los procesos de la organización y control de riesgo, delimitar responsabilidades de forma clara a todo el personal, llevar a cabo una mejor utilización del tiempo y los recursos y, por último, mejorar, si cabe, la motivación del personal (AU)

The Quality Management Systems make it possible to prioritize actions to maintain the safety and efficacy of health technologies. The Intensive Care Unit of our hospital has implemented a quality management plan, which has obtained accreditation as «Service Certificate that manages its activities according to UNE-EN ISO 9001:2008» standard. With the application of quality management system, it has been possible to detect the needs that the Service can cover in order to obtain the satisfaction of the patient, relative or health personnel of the other services of the hospital, to improve communications inside and outside of service, to secure greater understanding of the processes of the organization and control of risk, to delimit responsibilities clearly to all the personnel, to make better use of the time and resources and, finally, to improve the motivation of the personnel (AU)