Abstract
Objective:To determine the frequency and nature of complications of care in the medical intensive care unit (MICU).
Design:Prospective, observational study.
Setting:Seven-bed MICU in a teaching and referral VA hospital.
Patients:295 consecutive patients admitted to the MICU during a ten-month study period.
Interventions:None.
Measurements and main results:Forty-two patients (14%, 95% confidence interval 13%, 16%) experienced one or more complications during their MICU stays. Compared with other MICU patients, those experiencing complications tended to be older (mean age ± SD: 63.6±10.1 years vs 59.3±14.0 years, p<0.02) and more acutely ill (mean Acute Physiology Score ± SD: 18.3±8.0 vs 12.5±8.0, p=0.0001). These patients also had significantly longer MICU lengths of stay (mean ± SD: 12.3±14.7 days vs 3.1±4 days, p<0.0001) and higher hospital mortality rates (67% vs 27%, p<0.001). The 67% mortality rate among patients with complications significantly exceeded the expected mortality rate of 46% (calculated from the APACHE risk equation).
Conclusion:Complications of care in the MICU are not rare and may independently contribute to in-hospital mortality. The potential for complications must be recognized when considering ICU care.
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Rubins, H.B., Moskowitz, M.A. Complications of care in a medical intensive care unit. J Gen Intern Med 5, 104–109 (1990). https://doi.org/10.1007/BF02600508
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DOI: https://doi.org/10.1007/BF02600508