Intensive care improves patient survival

Introduction: Although intensive care is believed to improve patient (pt) outcome, there are little data to support this hypothesis. Methods: To evaluate the role of intensive care on patient outcome, all patients for whom admission was requested to an 8-bed ICU were prospectively evaluated over a 7 month period for APACHE II scores, 28-day and hospital mortality. Results: Admitted pts (290) had lower APACHE II scores (12.1±0.4) (mean ± SEM) and mortality (14%) than later (31) (15.6±1.5; 36%) and never admitted (61) pts (15.8±1.4; 47%) (p < 0.001. p < 0.001), respectively. Mortality was not different between admitted (5/132), later (0/9) and never (2/16) pts with APACHE II 0-10 (p = 0.23), but was for admitted (12/108), later (5/13) and never (3/11) pts with APACHE II 10-20 (p = 0.02) and borderline for admitted (18/36), later (6/8) and never (13/16) pts with APACHE II greater than 21 (p = 0.08). 28-day survival for the three groups controlling for APACHE II scores is seen below. (Figure Presented) Later admitted (Relative Risk = 1.4. p=0.4). Never admitted (Relative Risk = 2.5. p<0.01). Admitted (Relative Risk = 1.0) Conclusions: Admitted pts had lower APACHE II scores and 28-day and hospital mortality than refused pts. Admitting pts to ICU is associated with decreased mortality, especially in moderately ill pts.