Characteristics associated with analgesia ordering in the intensive care unit and relationships with outcome*
| Autor: | Amado X. Freire, Sarah Phelps, Bekele Afessa, Lisa Bridges, Pauline Cawley |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.drug_class Sedation medicine.medical_treatment Pain Critical Care and Intensive Care Medicine law.invention law medicine Humans Prospective Studies Prospective cohort study APACHE Quality of Health Care Mechanical ventilation business.industry Odds ratio Middle Aged Tennessee Intensive care unit Confidence interval Intensive Care Units Logistic Models Treatment Outcome Catheterization Swan-Ganz Anesthesia Sedative Multivariate Analysis Neuromuscular Blockade Female Analgesia medicine.symptom business Cohort study |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-200211000-00011 |
| Popis: | Objective: To describe clinical characteristics associated with analgesia utilization in the intensive care unit. Design: A prospective cohort study of adult patients admitted to a medical intensive care unit. Subjects: Four hundred adult patients. Setting: Twelve-bed medical intensive care unit of an inner-city, university-affiliated hospital. Measurements and Main Results: Collected data included demographics, sedation and neuromuscular blocking agents used, mechanical ventilation, hemodynamic monitoring, Therapeutic Intervention Scoring System score, Logistic Organ Dysfunction System (LODS) score, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Hospital outcome was noted. The odds ratio and 95% confidence intervals were determined by using multiple logistic regression analyses. Patients' mean age (±sD) was 47.8 ± 17.1 yrs; 58% were male, 84% African-American. Their APACHE II-predicted hospital mortality rate was 33%. Analgesics were used in 36% of patients. There were no differences in demographics, initial LODS score, APACHE II score, and mechanical ventilation use between patients who did and did not receive analgesics. Multiple logistic regression analysis showed that analgesic use was independently associated with sedation (odds ratio, 2.47; 95% confidence interval, 1.47-4.14), neuromuscular blockade (odds ratio, 4.98; 95% confidence interval, 1.85-13.41), and pulmonary artery flotation catheter utilization (odds ratio, 2.31; 95% confidence interval, 1.27-4.20). The median duration of mechanical ventilation was 5 days for those who received analgesia compared with 2 for those who did not (p = .0001). The median length of stay in the intensive care unit (4 vs. 2, p |
| Databáze: | OpenAIRE |
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