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Vol. 45. Issue 11.
Pages 533-539 (November 2009)
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Vol. 45. Issue 11.
Pages 533-539 (November 2009)
Original article
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A Year's Experience in an Intermediate Respiratory Care Unit
Cuidados respiratorios intermedios: un año de experiencia
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Myriam Aburtoa,
Corresponding author
, Cristóbal Estebana, Urko Aguirreb, Mikel Egurrolaa, Lander Altubea, Francisco Javier Morazaa, Alberto Capelasteguia
a Servicio de Neumología, Hospital de Galdakao, Galdakao, Bizkaia, Spain
b Unidad de Investigación-CIBER de Epidemiología y Salud Pública (CIBERESP), Hospital de Galdakao, Galdakao, Bizkaia, Spain
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Abstract
Background

The aim of this study was to describe the characteristics and results of patients admitted to an intermediate respiratory care unit (IRCU).

Patients and methods

We performed a 12-month prospective observational study of all the patients admitted to our IRCU during the study period. We analysed sociodemographic and clinical variables, the APACHE-II score, blood gas parameters, hospital stay duration, mortality, and hospital readmission.

Results

We evaluated 190 patients (64.2% men), with a mean age of 69.4 years. A score of greater than 2 on the Charlson index was recorded in 43.2% of patients. The mean APACHE-II score was 16.3 in the accident and emergency department and 14.3 on entering the IRCU. Fifty percent of the patients were admitted to receive ventilation and, of these, only 6 (5.7%) were admitted to be disconnected from the ventilator. The mean duration of stay in the IRCU was 3.7 days. The readmission rate was 12.7%. Mortality was 12.6% during hospitalisation and 11.6% 90 days after discharge.

Conclusions

The patients admitted to our IRCU were elderly, with considerable comorbidity and high mortality, both during hospitalisation and 90 days after being discharged from hospital. The results revealed no statistically significant differences (mean length of stay, readmission, mortality) according to the type of care administered to the patients (ventilation compared to monitoring).

Keywords:
Intermediate respiratory intensive care units
Non-invasive mechanical ventilation
Respiratory failure
Resumen
Introducción

El objetivo del presente estudio es describir las características y resultados de los pacientes ingresados en una unidad de cuidados respiratorios intermedios (UCRI).

Pacientes y métodos

Se ha realizado un estudio prospectivo y observacional de un año de duración, en el que se estudió a todos los pacientes ingresados en nuestra UCRI durante ese período. Se analizaron variables sociodemográficas, clínicas, escala APACHE-II, evolución gasométrica, duración de la estancia hospitalaria, mortalidad y reingreso hospitalario.

Resultados

Evaluamos a 190 pacientes (un 64,2% varones), con una edad media de 69,4 años. El 43,2% tenía un índice de Charlson mayor de 2. El APACHE-II fue de 16,3 en el Servicio de Urgencias y de 14,3 al entrar en la UCRI. El 50% de los pacientes ingresó para recibir ventilación, y de ellos sólo 6 (5,7%) ingresaron para la desconexión del ventilador. La duración media de la estancia en la UCRI fue de 3,7 días. La tasa de reingresos fue del 12,7%. La mortalidad fue del 12,6% durante el episodio de hospitalización, y del 11,6% a los 90 días del alta.

Conclusiones

Los ingresados en nuestra UCRI son pacientes mayores, con importante comorbilidad y mortalidad elevada, tanto durante el episodio de hospitalización como a los 90 días del alta hospitalaria. No hemos encontrado diferencias estadísticamente significativas en los resultados (estancia media, reingresos, mortalidad) en función del tipo de cuidados (ventilación frente a seguimiento) administrados al paciente.

Palabras clave:
Unidad de cuidados respiratorios intermedios (UCRI)
Ventilación mecánica no invasiva
Insuficiencia respiratoria
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