report prosafe project - europa · 2013-01-07 · prosafe project prosafe project-national report...

GiViTIGruppo Italiano per la Valutazione degli Interventi In Terapia Intensiva

ReportPROSAFE project

Year 2011

National report for general ICUs (5 ICUs)

HUNGARY

SESTANTE EDIZIONI - BERGAMO

PROSAFE project

PROSAFE project - National report for general ICUs (5 ICUs) - ITALYMay 2012

Authors of the report:Carlotta Rossi, Bergamo - ITGiovanni Nattino, Bergamo - ITFrank Bloos, Jena - DAkos Csomos, Budapest - HUJoanne Fleming, Padova - ITRafael Kapš, Novo Mesto - SITheodoros Kyprianou, Nicosia - CYMikaszewska-Sokolewicz Malgorzata, Warsaw - PLGiuseppe Nattino, Lecco - ITLuana Nava, Bergamo - ITDaniele Poole, Belluno - ITMervyn Singer, London - UKMario Tavola, Lecco - ITGuido Bertolini, Bergamo - IT

Software developers:Luca Antiga, Bergamo - ITMauro Bianchi, Bergamo - ITDaniele Crespi, Bergamo - ITObou Brissy, Bergamo - IT

GiViTI Coordinating CenterDaccò Center for Clinical Research on Rare DiseasesMario Negri Institute for Pharmacological ResearchVilla Camozzi - 24020 Ranica (BG), ITtel: +390354535313email: [email protected]

The PROSAFE project was realized thanks to a grant from European Union (DGSANCO Contract No. 2007331).GiViTI thanks Astellas, Bellco, Brahms, Hill-Rom for the unconditional grants for the year 2011.

2

PROSAFE project

Contents

Preface 5

The project 7

Data collection 7

The reports 7

Description of the statistics 8Project participation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Description of the hospitals and ICUs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Study flow-chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Description of patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Statistics 15Project participation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Description of hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Description of ICUs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Study flow-chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21Description of adult patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Description of adult patients with LOS>=24 hours evaluated in the GiViTI model . . . . . . . . . . . . . . . 35Description of adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model . . . . . . . . 47Description of adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model . . . . . . 59Description of adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTI model . . . . 71Description of adult patients with LOS<24 hours evaluated in the GiViTI model . . . . . . . . . . . . . . . . 83Description of adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model . . . . . . . 95

Appendix 107Coauthors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

3

PROSAFE project

4

PROSAFE project

Preface

The tenth year of the Margherita project coincided with a radical change. Thanks to funding from the European Union

(DG SANCO contract No. 2007331), the project crossed the Italian borders to become PROSAFE and is now shared

by intensive care units in Cyprus, Hungary, Italy, Poland, Slovenia, and Switzerland, not to mention the involvement of

the units of the non-government organization EMERGENCY, in Afghanistan and Sudan.

However, PROSAFE cannot be considered the mere extension of the existing project. The Margherita project has

instead been entirely overhauled: from the case report form to the data collection software, from the statistical

analyses to the yearly reports. Such important changes have also caused some problems and discontent, resulting in

the decline, for the first time in ten years, in the number of Italian ICUs, from 238 to 210 participants, partly offset by

15 new non-Italian centers. Despite these numbers, however, we must consider PROSAFE to be a complete success,

far beyond all expectations.

The work behind these pages has continued for over three years and involved all the European centres in a

partnership that has proven extremely fruitful and enjoyable, and has produced solid friendships. This very element

has contributed important added value to the project. Indeed, only when you build relationships based on genuine

collaboration can you achieve results that exceed the sum of individual expertise.

Many tools have been developed to handle the PROSAFE project: the main software, the translation manager, the

registration tool, the technical assistance program, the website, the data analyzer, the report generator, etc. All are

extremely complex and advanced and have clearly required extraordinary commitment. They still have to be updated

and improved, but they mark the achievement of an important milestone and the best investment for the future of the

project.

This report opens a new course for the evaluation and improvement of quality of care in intensive care medicine.

It may be more challenging than before, but judging from the international arena being created and the ideas and

prospects being generated, it will undoubtedly be even more exciting and beneficial.

5

PROSAFE project

6

PROSAFE project

The project

The PROSAFE project was conceived as an observational project for the continuous electronic collection of data on

patients admitted to intensive care units (ICUs). The objectives of the project are to:

• standardize the procedures for collecting data on admitted patients;

• analyse the activity carried out in terms of both clinical results achieved and resources used;

• gather information on the collected case series for research and/or routine clinical management purposes;

• promote comparison among ICUs, on the basis of detailed epidemiological research work, with a view to improving

the quality of the care provided.

In addition to these general objectives, the PROSAFE project provides a tool that serves as the operating base for

all research projects undertaken by the individual ICUs, both under the umbrella of the GiViTI group and at local

level. The PROSAFE program, by virtue of its modular structure, is designed to smoothly integrate the collection of

basic data (the PROSAFE ’core’) with the collection of specific data for research projects focused on various different

topics (the PROSAFE ’petals’).

The Petals functioning in 2011 in Italy were:

• the Infections Surveillance Petal, designed to describe the epidemiology of infections in ICUs in Italy, focusing

specifically on the identification and study of the main risk and prognostic factors for infections, with a view to

comparing the various ICUs in terms of incidence of infections and their severity, prevalent bacterial flora and

multiresistant germs;

• the Cardiosurgical Petal, whose aim is to describe in detail the characteristics of patients admitted to the ICU and

subject to one or more cardiosurgical procedures;

• the Crimyne 2 Petal, designed to assess the accuracy (in terms of sensitivity and specificity), in the diagnosis of

CRIMYNE (CRitical Ilness MYopathy and NEuropathy), of the simplified peroneal CMAP test, using the complete

ENG-EMG test as the diagnostic gold standard;

• the StART Petal, whose objective is to assess the appropriateness of ICU bed utilization by comparing the level of

care required by admitted patients with the level of care that can be provided using available resources.

The information currently collected in the program ’core’ refers to personal patient data, information on origin, reason

for admission and whatever else GiViTI has, over the years, determined to be needed to best describe patients

admitted to intensive care.

Data collection

The PROSAFE software is distributed free of charge to all ICUs taking part in the project. To date, 355 ICUs have

joined the project: 313 Italian and 42 foreign ICUs. 290 ICUs collected data during 2011 for a total of 88578 patients

registered in PROSAFE. Only the ICUs that collected valid data (225) for a period of over 4 months were included in

the aggregate analyses. On the whole, therefore, the assessment was based on a total of 73163 patients admitted to

intensive care during 2011.

The reports

The Coordinating Centre (GiViTI) produces the following reports (only for subgroups composed of at least 5 ICUs):

7

PROSAFE project

1. The (Italian and Hungarian) national report on the general (medical/surgical) ICUs. This first report includes the

logistic regression model to assess performance in the various ICUs taking part in the project. The statistics for

the most representative regions can be downloaded from the GiViTI website (www.giviti.marionegri.it).

2. The (Italian) national report on the surgical ICUs.

3. The (Italian) national report on the neurosurgical ICUs.

4. The personalized report for each individual centre, in Italian or English, which has different sections according to

type of ICU and a similar structure to the national report, is designed to foster precise but user-friendly interpretation

of the various values for predicting hospital mortality.

All reports (except for the personalized reports, sent to the project Contact person and the Director of the ICU) can

be downloaded from the PROSAFE Project section of the GiViTI website (www.giviti.marionegri.it). An analysis

application form is available on the GiViTI website to obtain a report on particular subgroups of patients in which

each unit may be interested.

Description of the statistics

Project participation

The table on page 17 summarizes the participation in the project of the 225 ICUs which collected valid data in 2011

for a period of at least 4 months.

Description of the hospitals and ICUs

This section presents the organizational-structural features of the ICUs included in the report. The information (except

for the information shown in the grey box, which is the result of joint analysis of data reported at the time of registration

and those collected during the year via the software) is taken from the PROSAFE project registration forms. Absolute

numbers, percentages and the number of missing data are reported for the categorical variables; the mean, standard

deviation, median and Q1 (first quartile: the value below which lie 25% of the population) and Q3 (third quartile: the

value below which lie 75% of the population) serve as indicators for the continuous variables. Data on the number of

staffed beds, total admissions in 2011 and ICU stay days were used to calculate indicators of utilization, i.e. indicators

able to measure utilization levels and healthcare facility activity levels.

The bed occupation rate expresses bed occupancy as a percentage value, by dividing total ICU stay days recorded

at a given time by the total number of days in the period in question multiplied by the number of staffed beds. The

product corresponds to the ICU’s total availability for admissions (daily number of available beds); the closer total

ICU stay days are to total availability, the more the occupation rate tends towards 100%. Occupation rate can even

exceed 100% when a new patient is admitted to a bed that became vacant on the same day.

Occupation rate =ICU stay days

Days×Number of beds(1)

The rotation index expresses the mean number of patients ’staying’ in a bed in one year. It is calculated by dividing

the number of admissions by the number of beds. Data collected for less than one year have to be extrapolated.

Rotation index =Number of patients

Number of beds(2)

8

PROSAFE project

The turnover interval expresses the period of time in which a bed remains vacant between two consecutive patients.

It is calculated by dividing the number of days with vacant beds by the number of patients admitted during the period

in question, giving mean unoccupied time per bed. It is calculated by dividing the number of days with unoccupied

beds by the number of patients admitted in the period in question. This gives the mean unoccupied time per bed.

This indicator is expressed in hours.

Turnover = 24× (Number of beds×Days)− ICU stay days

Number of patients(3)

Study flow-chart

The flow chart, or tree diagram, on page 21 presents the various subgroups of analysed patients. PROSAFE has a

very accurate indicator of the completeness and validity of the data entered on each patient, i.e. status.

The program envisages 5 status levels:

• status 1 - the patient record presents errors or unsolved warnings;

• status 2 - the record is incomplete, there are still missing data;

• status 3 - the patient has been discharged from the ICU, the clinical data are all entered and have undergone

congruency checks; only hospital outcome is missing;

• status 4 - record complete and free of errors;

• status 5 - record free of errors but incomplete; the missing data are irretrievable.

Patients with status 1, 2 and 5 data are clearly incomplete.

It would be wrong to omit only patients with incomplete data (in status 1, 2 and 5) from the analyses since this could

skew the estimates because of a so-called ’selection bias’. Patients with incomplete data may instead represent

a special population subgroup. If only these patients were omitted from the analysed group, the statistics would

no longer represent the whole group. It is plausible to assume, for example, that the majority of the patients for

whom hospital outcome is missing were discharged alive from hospital, since it is much easier and quicker to retrieve

information on hospital outcome when a patient has died. Calculating statistics on hospital mortality in the whole

group of patients would result in mortality being incorrectly overestimated.

To address this problem it was decided to omit from each individual ICU’s data any patients recruited during months

when the validity percentages were below a high threshold (90%). Another check performed to reduce the risk of

selection bias is to analyse the number of patients admitted per month. If the number of patients admitted in one

or more months differs significantly from the mean number of monthly admissions (with a threshold arbitrarily set

at a mean of +/- 2 trimmed SD), or if the variability in the number of admissions is too high (variation coefficient

above 40%), a warning message will appear asking for the entered data to be checked. To correctly participate in the

PROSAFE project, all patients consecutively admitted to the ICU must be registered in the software on a continuous

basis throughout the year; any marked swings in the number of admissions should suggest that there may be patient

registration ’gaps’. It is, however, impossible to distinguish between registration ’gaps’ and periods in which there is a

real reduction/increase in admissions. Hence our objective is to draw attention to potential problems by asking each

individual centre for feedback.

To more clearly illustrate the selection methods used in the choice of valid data, we present an extract from the data

validity report of a randomly selected, anonymized ICU.

From January to December, Centre XX000 recruits a total of 269 patients. The first table and the bar graph show the

9

PROSAFE project

number of monthly admissions to intensive care. In this case, a warning will appear at the bottom of the bar graph

asking for confirmation of the entered data.

The second table divides the recruited patients by admission month and form completion status. Overall, the ICU in

question presents complete data for the majority of recruited patients. Only 7 patients still present incomplete data.

The final graph shows level of data completeness in the various months.

According to our elimination criterion, the overall analysis of hospital mortality will exclude those patients admitted in

the month of May since they present a validity percentage below 90% (in that month, information on hospital outcome

was still missing for 3 out of 24 patients). Accordingly, 245 patients have valid data for this type of analysis (after

subtracting the 24 patients admitted in the month of May from the total of 269 patients).

10

PROSAFE project

Description of patients

These sections of the report present the results of the analyses conducted on the group of patients with valid data.

Patients admitted in the months with less than 90% admissions in statuses 3 and 4 are omitted from the analysis

group. This part presents patient characteristics at ICU admission and during ICU stay, severity scores, process

indicators, and outcomes for the various patient subgroups.

Absolute number, percentage and number of missing data are reported for the categorical data, while mean, standard

deviation, median, interquartile range (Q1-Q3) and minimum and maximum range are reported for continuous

variables. The acronym 95% CI indicates the 95% confidence interval of the estimate.

Below are a few tips on how to correctly interpret the analyses.

BMI The calculation of Body Mass Index is based on weight and height values, with the following formula:

BMI =weight (kg)

height (m)2(4)

The categories of underweight, overweight and obese are determined according to the following criteria: underweight if

BMI<20 (males) or BMI<19 (females); normal weight if 20<=BMI<=25 (males) or 19<=BMI<=24 (females); overweight

if 25<BMI<=30 (males) or 24<BMI<=29 (females); obese if BMI>30 (males) or BMI>29 (females).

Stay before ICU Days spent between admission to hospital and admission to ICU.

Reason for transfer from other ICU The reported items refer to the following reasons:

• Specialist expertise -> specialist expertise within the hospital;

• Step-up care -> management of high complexity critical patient;

• Logistical/organizational reasons -> continuation of treatment in stabilized patient (transfer for logistic/ organizational

reasons);

• Step-down care-> continuation of treatment in a non-specialist environment.

Surgical interventions on admission (top 10) This lists the top 10 surgical interventions, divided by elective surgery

and emergency surgery patients, operated between 7 days prior to and one day after admission to the ICU.

11

PROSAFE project

Multiple trauma The category multiple trauma is defined by the presence of trauma in two or more regions.

SAPSII The score cannot be calculated if GCS (first 24 hours) is unassessable.

The SAPSII score for individual patients can become the probability of dying in hospital. This is performed by the

following formula:

Predicted hospital mortality =eLogit

1 + eLogit(5)

where

Logit = −7.763 + 0.074× SAPSII + 0.997× ln (SAPSII + 1) (6)

PELOD The PELOD score for individual pediatric patients can become the probability of dying in ICU. This is

performed by the following formula:

Predicted ICU mortality =1

1 + e7.64−0.30×PELOD(7)

Severity evolution (of infections) The severity of infection on admission is shown in the rows. Maximum severity

reached during ICU stay is indicated in the columns. The table reports the absolute numbers and row percentages by

which to assess the evolution of infection severity. For example, in the case below, the severity of the infection did not

worsen during ICU stay in 15 out of the 17 patients admitted with SEVERE SEPSIS (15/17=88.2%). Conversely, the

condition of SEVERE SEPSIS developed into SEPTIC SHOCK in 2 patients (2/17=11.8%).

VAP Forms of pneumonia associated with invasive ventilation are defined as VAP (pneumonia onsetting after the 2nd

day of ventilation or developing within 2 days of the end of ventilation).

Incidence of VAP Two different incidence rates are presented:

Incidence of VAP =Number of patients with VAP during stay

Mechanical ventilation days pre VAP× 1000 (8)

where the variable mechanical ventilation days pre-VAP corresponds to the total number of mechanical ventilation

days pre-VAP of all patients admitted to the ICU. It is equal to the total duration of mechanical ventilation for patients

who do not develop VAP and to the difference between the date of onset of VAP and the start date of mechanical

ventilation for infected patients. The mechanical ventilation days in patients who were discharged or died within 2

12

PROSAFE project

days of the start of ventilation are excluded from the denominator.

Incidence of VAP =Number of patients with VAP during stay

(Mechanical ventilation days pre VAP)/8× 100 (9)

The second rate is only a reworking of the previous one, to simplify interpretation of the data. It answers the question:

’Out of 100 patients ventilated for 8 days in the ICU, how many develop VAP?’. The 8-day cut off has been set by

convention. The rates are accompanied by 95% confidence intervals.

Incidence of CR-BSI Just like VAP, two incidence rates are presented for catheter-related blood stream infections:

Incidence of CRBSI =Number of patients with CRBSI during stay

CVC days pre CRBSI× 1000 (10)

Incidence of CRBSI =Number of patients with CRBSI during stay

(CVC days pre CRBSI)/12× 100 (11)

The second one responds to the question ’Out of 100 theoretical patients catheterized for 12 days in the ICU, how

many will develop catheter-related blood stream infections?’.

Invasive ventilation (approach) The reported items refer to the following scenarios:

• Due to pulmonary failure -> invasive ventilation in a patient with hypoxic and/or hypercapnic respiratory failure;

• For airway mainteinance -> invasive ventilation in a patient without respiratory failure, to support airways (e.g. coma

patient);

• In weaning -> final part of invasive ventilation in a patient admitted for weaning from ventilation.

Non invasive ventilation (approach) The reported items refer to the following scenarios:

• Non invasive ventilation only -> non-invasive ventilation as the only ventilatory approach to the patient;

• Non invasive ventilation failed -> non-invasive ventilation immediately followed by patient intubation;

• For weaning -> non-invasive ventilation started within one day of the end of invasive ventilation.

Surgical interventions during stay (top 10) The surgical interventions performed from the second day of stay.

Reason of transfer to other ICU See the item ’Reason of transfer from other ICU’.

Hospital mortality Statistics on hospital outcome (indicated with an asterisk, where necessary) involve the subgroup

of patients with valid data for this variable or patients admitted during the months when over 90% of patients were in

status 4, after excluding readmissions from another hospital ward.

Readmissions Only readmissions from other hospital wards are considered.

ICU stay (days) Length of pre-ICU, post-ICU and hospital stay are simply calculated as the difference between

dates. Calculation of ICU stay can be optimized by using time of patient admission and discharge. The difference

between the discharge date and the admission date is calculated. 1 is added if the patient is admitted before 12:00

13

PROSAFE project

and discharged after this time. Conversely, 1 is subtracted if the patient is admitted after midday and discharged

before midday. If the length of stay in the ICU is equal to 0, length of stay is entered as 1.

14

PROSAFE project

Statistics

15

PROSAFE project

16

PROSAFE project

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Ann

o20

11P

roje

ctpa

rtic

ipat

ion*

TYP

E

Nat

ion

Gen

eral

Car

dios

urgi

cal

Sur

gica

lN

euro

surg

ical

Pedi

atric

sO

ther

Tota

l

Afg

hani

stan

1IC

Us

253

patie

nts

1IC

Us

253

patie

nts

Cyp

rus

1IC

Us

782

patie

nts

1IC

Us

782

patie

nts

Italy

163

ICU

s50

199

patie

nts

14IC

Us

6731

patie

nts

10IC

Us

4449

patie

nts

13IC

Us

3907

patie

nts

3IC

Us

929

patie

nts

7IC

Us

2792

patie

nts

210

ICU

s69

007

patie

nts

Pola

nd4

ICU

s38

1pa

tient

s1

ICU

s34

patie

nts

5IC

Us

415

patie

nts

Slo

veni

a1

ICU

s11

6pa

tient

s1

ICU

s41

6pa

tient

s2

ICU

s53

2pa

tient

s

Hun

gary

5IC

Us

1882

patie

nts

1IC

Us

292

patie

nts

6IC

Us

2174

patie

nts

Tota

l17

4IC

Us

5349

7pa

tient

s14

ICU

s67

31pa

tient

s12

ICU

s48

57pa

tient

s13

ICU

s39

07pa

tient

s3

ICU

s92

9pa

tient

s9

ICU

s32

42pa

tient

s22

5IC

Us

7316

3pa

tient

s

*Are

cons

ider

edas

adhe

ring

the

ICU

sw

ithat

leas

t4m

onth

sof

valid

com

pila

tion.

17 Project participation

PROSAFE project

18

Description of hospitals (N=5) - Year 2011

Number of beds in hospital N %

< 300 beds 1 20.0300 - 800 beds 2 40.0

> 800 beds 2 40.0Missing 0

Non surgical specialties N %

Cardiology 4 80.0Pneumology 3 60.0Nephrology 3 60.0

Infectious diseases 2 40.0Pediatrics 3 60.0

Neonatology 2 40.0Neurology 5 100.0

Haematology 1 20.0

Surgical specialties(independent ward) N %

Neurosurgery 2 40.0Cardiosurgery 0 0.0

Major vascular surgery 3 60.0Thoracic surgery 2 40.0Pediatric surgery 1 20.0

Transplantation activities (excludingcorneal transplants)

0 0.0

Surgical specialties(procedures only) N %

Neurosurgery 1 25.0Cardiosurgery 0 0.0

Major vascular surgery 2 50.0Thoracic surgery 2 40.0Pediatric surgery 2 50.0

Transplantation activities (excludingcorneal transplants)

1 25.0

Type of ICUs present in hospital N %

General 5 100.0Medical 0 0.0Surgical 0 0.0

Neurosurgical 0 0.0Cardiosurgical 0 0.0Coronary unit 4 80.0

Burns 0 0.0Transplants 0 0.0

Pediatrics 2 40.0High dependency unit 4 80.0

Respiratory Intensive Care Unit 0 0.0Other 1 20.0

Services/activities available in H N %

Invasive radiology 3 60.0Invasive cardiology 2 40.0

Endoscopy 5 100.0Microbiology 3 75.0

Emergency department 4 80.0

1 ICU 2 ICUs 3 ICUs 4 ICUs 5 ICUs 6 ICUs 7 ICUs > 7 ICUs

Number of ICUs in hospital

0.0

0.5

1.0

1.5

2.0

0

1

2

0

1

0

1

0

PROSAFE project

19 Description of hospitals

Description of ICUs (N=5) - Year 2011

Number of functioning bedsMean 12.0

SD 3.2Median 12Q1-Q3 10-14

Missing 0

University affiliation N %

Yes 1 20.0No 4 80.0

Missing 0

Number of physicianMean 14.6

SD 12.4Median 10Q1-Q3 8-19

Missing 0

Physicians N %

Dedicated to ICU only 1 20.0Dedicated to ICU on a rotation basis 0 0.0

Dedicated to ICU only and on arotation basis

4 80.0

Missing 0

Beds per physician (average)Mean 5.0

SD 1.6Median 4.8Q1-Q3 4-6.4

Missing 0

Beds per physician (night-time)Mean 5.9

SD 3.3Median 6Q1-Q3 4-8

Missing 0

Number of nursesMean 25.8

SD 8.2Median 28Q1-Q3 27-28

Missing 0

Nurses N %

Dedicated to ICU only 3 60.0Dedicated to ICU on a rotation basis 0 0.0

Dedicated to ICU only and on arotation basis

2 40.0

Missing 0

Beds per nurse (average)Mean 2.7

SD 0.4Median 2.8Q1-Q3 2.4-2.9

Missing 0

Beds per nurse (night-time)Mean 3.4

SD 0.7Median 3.5Q1-Q3 3.3-4

Missing 0

Biomedical devices per bed Mean SD Q1-Q3

Basic ICU monitors (ECG, NIBP, SaO2) 1.0 0.1 1.0-1.0Advanced ICU Monitors with invasive pressure 0.8 0.4 0.6-1.0

Cardiac output monitors 0.4 0.4 0.2-0.2Ventilators 1.0 0.4 0.8-1.0

Syringe pumps 2.2 0.8 1.4-2.6IV. infusion pumps 1.4 0.9 0.6-2.0

Enteral nutrition pumps 0.5 0.2 0.4-0.6

Biomedical equipment in ICU N %

Transoesophageal ECHO (TOE) 0 0.0Basic ultrasound with linear probe 2 40.0

Advanced ultrasound with abdominal probe 1 20.0Blood gas analyser 4 80.0

Haemodialysis/haemofiltration system 3 60.0Transport ventilator 4 80.0

Fiberoscope 4 80.0

Patients admittedMean 413.2

SD 141.2Median 363.8Q1-Q3 348.9-487.3

Occupancy rate (%)Mean 55.5

SD 13.1Median 60.6Q1-Q3 43.1-62.3

Rotation index (patients/bed)Mean 31.8

SD 7.7Median 30.4Q1-Q3 24.8-37.5

Turnover (hours)Mean 119.7

SD 52.9Median 108.3Q1-Q3 104.5-109.6

Data source: ICU registration form of PROSAFE project.

PROSAFE project

Description of ICUs 20

National report for general ICUs (5 ICUs) - Year 2011Study flow-chart

(1) Patients older than 17 years are considered ADULT.(2) Patients under 17 years old are considered PEDIATRIC patients.(3) Patients evaluated by the GiViTI model of hospital mortality are those with all the variables of the model completed, including the hospitaloutcome.(4) Patients transferred to other ICU are excluded.

PROSAFE project

PARTICIPATING ICUs TOTAL RECRUITED PATIENTSN=210 N=69007

GENERAL ICUs TOTAL RECRUITED PATIENTSN=5 N=1882

PEDIATRIC patientsadmitted in months

with more than 90% ofpatients in status 3 or 4(2)

N=2

ADULT patients admittedin months with morethan 90% of patients

in status 3 or 4(1)

N=1880

Patients admitted inmonths with less than

90% of patients in status3 or 4, or age missing

N=0

REPORT

1. All patients

Patients admitted inmonths with less than

90% of patients instatus 4 or readmissions

ADULTS PEDIATRICS

N=81 N=1

ADULT patientsadmitted in months

with more than 90% ofpatients in status 4(1)

N=1799

PEDIATRIC patientsadmitted in months

with more than 90% ofpatients in status 4(2)

N=1

Patients non CS whostayed MORE than

24 hours in ICUN=1618

Patients non CS whostayed LESS than24 hours in ICU

N=177

Patients with CardiacSurgery (CS)

or LOS missing.

N=4

Patients evaluatedby the MODEL(3)

N=1612

Patients evaluatedby the MODEL(3)

N=175

Patients evaluated bythe MODEL (PELOD)(4)

N=0

REPORT

1. All patients2. Non surgical patients3. Elective surgical

patients4. Emergency surgical

patients

REPORT

1. All patients2. Elective surgical

patients

REPORT

1. All patients

21 Flow-chart

PROSAFE project

22

National report for general ICUs - Year 2011Characteristics on admission - Adult patients

Patients (N): 1880

Sex N %

Male 1052 56.0Female 828 44.0Missing 0

Age (years) N %

17-45 264 14.046-65 753 40.166-75 472 25.1>75 391 20.8

Missing 0Mean 62.2

SD 15.3Median 64Q1-Q3 54-73

Min-Max 17-97

Body mass Index (BMI) N %

Underweight 165 8.8Normal 794 42.4

Overweight 542 28.9Obese 372 19.9

Missing 7

Pregnancy statusFemales (N=828) N %

Not fertile 330 40.0Not pregnant/Unknown 484 58.6

Currently pregnant 1 0.1Post partum 11 1.3

Missing 2

Comorbidities N %

No 252 13.4Yes 1623 86.6

Missing 5

Comorbidities (top 10) N %

Hypertension 1172 62.5Peripheral vascular disease 462 24.6

NYHA class II-III 387 20.6Any tumour without metastasis 371 19.8

Cerebrovascular disease 320 17.1Diabetes Type II without insulin tr. 306 16.3

Moderate COPD 305 16.3Arrhythmia 242 12.9

Myocardial infarction 220 11.7Peptic ulcer disease 158 8.4

Missing 5

Stay before ICU (days)Mean 5.3


Missing 5

Source of admission N %

Same hospital 1813 96.6Other hospital 63 3.4

Missing 4

Ward of admission N %

Medical ward 305 16.3Surgical ward 942 50.2

Emergency room 488 26.0Other ICU 51 2.7

High dependency care unit 89 4.7Missing 5

Reason for transfer fromOther ICU (N=51) N %

Specialist expertise 11 21.6Step-up care 18 35.3

Logistical/organizational reasons 12 23.5Step-down care 10 19.6

Missing 0

Ward of admissionSame hospital (N=1813) N %




Ward of admissionOther hospital (N=63) N %




Scheduled admission N %

No 1419 75.7Yes 456 24.3

Missing 5

PROSAFE project

23 Adult patients


Trauma N %

No 1655 88.3Yes 220 11.7

Multiple trauma 90 4.8Missing 5

Surgical status N %

Non surgical 925 49.3Elective surgical 546 29.1

Emergency surgical 404 21.5Missing 5

49.3%

29.1%

21.5%

Surgical status

Non surgicalElective surgicalEmergency surgical

Source of admissionSurgical pts. (N=950) N %

Operating theatre of surgical ward 703 74.0Operating theatre of emergency room 21 2.2

Surgical ward 128 13.5Other 98 10.3

Missing 0

Surgical interventions (top 10)Elective surgical (N=546) N %

Thoracic surgery 246 45.1Gastrointestinal surgery 99 18.1

Nephro/Urological surgery 60 11.0Peripheral vascular surgery 58 10.6Abdominal vascular surgery 26 4.8

Neurosurgery 16 2.9Orthopaedic surgery 15 2.7

Other surgery 14 2.6Pancreatic surgery 11 2.0

ENT surgery 10 1.8Missing 0

TimingElective surgical (N=546) N %

From -7 to -3 days 32 5.9From -2 to -1 days 18 3.3

On ICU admission day 517 94.7The day after ICU admission 14 2.6

Missing 0

Surgical interventions (top 10)Emergency surgical (N=404) N %

Gastrointestinal surgery 181 44.8Neurosurgery 77 19.1

Orthopaedic surgery 37 9.2Thoracic surgery 29 7.2

Biliary tract surgery 22 5.4Nephro/Urological surgery 19 4.7

Other surgery 18 4.5Peripheral vascular surgery 13 3.2

Hepatic surgery 9 2.2Abdominal vascular surgery 9 2.2

Missing 0

TimingEmergency surgical (N=404) N %



Missing 0

Non surgical interventions N %

None 1767 94.2Elective 37 2.0

Emergency 71 3.8Missing 5

Non surgical interventionsElective (N=37) N %

Interventional radiology 3 8.1Interventional neuroradiology 2 5.4

Interventional endoscopy 1 2.7Interventional cardiology 0 0.0

Missing 31

Non surgical interventionsEmergency (N=71) N %

Interventional endoscopy 34 47.9Interventional cardiology 18 25.4Interventional radiology 8 11.3

Interventional neuroradiology 5 7.0Missing 6

PROSAFE project

Adult patients 24


Reason for admission N %

Monitoring/Weaning 403 21.5Post surgical weaning 188 10.1

Surgical monitoring 149 8.0Post interventional weaning 0 0.0

Interventional monitoring 1 0.1Non surgical monitoring 57 3.1

Missing 8Admission for procedures/treatments 338 18.0

Intensive Treatment 1126 60.1Only ventilatory support 515 27.5

Only cardiovascular support 151 8.1Ventilatory and cardiovascular support 460 24.5

Missing 0Palliative Sedation 3 0.2

Diagnosis of death/Organ donation 5 0.3Missing 5

0 1 2 3 >3

Number of failures (%)

0

20

40

60

80

100

28.6%24.0%

19.5%14.0% 14.0%

Failures on admission N %

No 537 28.6Yes 1343 71.4

A: Respiratory failure 788 41.9B: Cardiovascular failure 611 32.5

C: Neurological failure 189 10.1D: Hepatic failure 44 2.3

E: Renal failure (AKIN) 648 34.5F: Acute skin failure 2 0.1G: Metabolic failure 761 40.5

H: Coagulation failure 55 2.9Missing 0

Failures on admission (top 10) N %

A 173 9.2ABEG 133 7.1

G 122 6.5BEG 74 3.9

E 73 3.9AG 68 3.6EG 65 3.5

ABG 62 3.3B 62 3.3

AE 54 2.9Missing 0

Respiratory failure N %

None 905 48.1Only hypoxic failure 497 26.4

Only hypercapnic failure 49 2.6Hypoxic-hypercapnic failure 76 4.0Intubation for airway maint. 353 18.8

Missing 0

Cardiovascular failure N %

None 1269 67.5Without shock 146 7.8

Cardiogenic shock 131 7.0Septic shock 185 9.8

Haemorrhagic/hypovolemic shock 70 3.7Hypovolemic shock 31 1.6Anaphylactic shock 0 0.0Neurogenic shock 8 0.4

Other shock 17 0.9Mixed shock 23 1.2

Missing 0

Neurologic failure N %

None 1321 92.6Cerebral coma 34 2.4

Metabolic coma 29 2.0Postanoxic coma 41 2.9

Toxic coma 2 0.1Missing or not evaluable 453

Renal failure (AKIN) N %

None 1227 65.4Mild 340 18.1

Moderate 124 6.6Severe 184 9.8Missing 5

Metabolic failure N %

None 1114 59.4pH <= 7.3, PaCO2 < 45 mmHg 287 15.3

Base deficit >= 5 mmol/L, lactate >1.5x 474 25.3Missing 5

PROSAFE project

25 Adult patients


Clinical conditions on admission N %

Respiratory 569 30.3Atelectasis 134 7.1

Pneumothorax/Pneumomediastinum 110 5.9Pleural effusion 101 5.4

Lung cancer 90 4.8Acute exacerbation of COPD 86 4.6

Cardiovascular 533 28.4Cardiac arrest 135 7.2

Left heart failure with pulmonary edema 128 6.8Acute myocardial infarction 99 5.3

Left heart failure without pulm. edema 97 5.2Acute severe arrhythmia: tachycardias 92 4.9

Neurological 224 11.9Metabolic/postanoxic encephalopathy 69 3.7

Cerebral artery stroke 59 3.1Seizures 46 2.5

Spontaneous Subarachnoid haemorrhage 18 1.0Spontaneous Intraparenchymal bleeding 19 1.0

Gastrointestinal and hepatic 314 16.7Digestive tract malignancy 69 3.7

Gastrointestinal bleeding: upper tract 41 2.2Gastrointestinal perforation 35 1.9

Acute pancreatitis 32 1.7Liver Dysfunction Syndrome 32 1.7

Trauma (anatomical districts) 220 11.7Head 128 6.8Chest 88 4.7

Pelvis/bone/joint & muscle 65 3.5Spine 51 2.7

Abdomen 30 1.6Major vessels injury 11 0.6

- 0 0.0Other 502 26.8

Metabolic disorder 253 13.5Nephrourologic disease 102 5.4

Other disease 76 4.1Coagulation disorder 55 2.9

Acute intoxication 44 2.3Post transplantation 0 0.0

- 0 0.0- 0 0.0

Infections 757 40.4Pneumonia 333 17.8

L.R.T.I. other than pneumonia 92 4.9NON-surgical urinary tract infection 63 3.4NON-surgical secondary peritonitis 56 3.0

Post-surgical peritonitis 36 1.9Clinical sepsis 32 1.7

NON-surgical skin/soft tissue infection 31 1.7Primary peritonitis 30 1.6

Gastroenteritis 26 1.4Cholecystitis/cholangitis 24 1.3

Missing 5

Trauma (anatomical districts) N %

Head 128 6.8Skull fracture 55 2.9

Traumatic Subdural haemathoma 53 2.8Traumatic subarachnoid haemorrhage 53 2.8

Cerebral contusion/laceration 48 2.6Traumatic Intraparenchimal bleeding 28 1.5

Spine 51 2.7Vertebral fracture, without deficit 30 1.6Cervical injury, incomplete deficit 5 0.3

Tetraplegia 6 0.3Chest 88 4.7

Traum. haemothorax/pneumothorax 60 3.2Other injuries of the chest 39 2.1

Severe lung contusion/laceration 36 1.9Abdomen 30 1.6

Spleen: Massive rupture 7 0.4Kidney: Rupture/laceration 7 0.4

Bowel transection/perforation 5 0.3Pelvis/bone/joint & muscle 65 3.5

Long bones fracture 57 3.0Multiple fracture of the pelvis 14 0.7

Very severe or open fracture of the pelvis 1 0.1Major vessels injury 11 0.6

Major thoracic vessels: transection 5 0.3Aorta: rupture/dissection 5 0.3

Neck vessels: dissection/transection 1 0.1Miscellaneous 0 0.0

- 0 0.0- 0 0.0- 0 0.0

Missing 5

Infection severity on admission N %

None 1118 59.6Infection with or without SIRS 395 21.1

SEVERE SEPSIS 158 8.4SEPTIC SHOCK 204 10.9

Missing 5

52.2%

20.9%

26.9%

Infection severity on admission

Infection with or without SIRSSEVERE SEPSISSEPTIC SHOCK

Patients infected (N=757)

PROSAFE project

Adult patients 26

National report for general ICUs - Year 2011Severity scores - Adult patients

3 4 5 6 7 8 9 10 11 12 13 14 15

Glasgow Coma Scale (%)

0

10

20

30

40

50

60

70On admissionWorst value in the first 24 hours GCS (admission)

Median 15Q1-Q3 12-15

Not evaluable 448Missing 5

GCS (first 24 hours)Median 15Q1-Q3 12-15


0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

SAPSIIMean 34.5

SD 20.2Median 30Q1-Q3 19-47


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

5

10

15

20

25

SOFAMean 4.2



PROSAFE project

27 Adult patients

National report for general ICUs - Year 2011Characteristics during the stay - Adult patients

Complications during the stay N %

No 1075 57.3Yes 800 42.7

Missing 5

Failures during the stay N %

No 1564 83.2Yes 316 16.8





Failures during the stay (top 10) N %

B 82 4.4A 47 2.5E 35 1.9G 16 0.9

BE 15 0.8AB 11 0.6

BCE 9 0.5AE 8 0.4

C 7 0.4D 7 0.4

Missing 0

Respiratory failure occured N %

None 1771 94.5Intubation for airway maint. 30 1.6

Hypoxic failure 74 3.9Hypercapnic failure 12 0.6

Missing 5

Cardiovascular failure occured N %

None 1717 91.6Cardiogenic shock 50 2.7

Hypovolemic shock 13 0.7Haemorrhagic/hypovolemic shock 14 0.7

Septic shock 72 3.8Anaphylactic shock 0 0.0Neurogenic shock 9 0.5

Other shock 10 0.5Missing 5

Neurological failure occured N %



Missing 5

Renal failure occured (AKIN) N %

None 1761 93.9Mild 22 1.2



Respiratory 163 8.7Pleural effusion 68 3.6

Pneumothorax/Pneumomediastinum 41 2.2Atelectasis 26 1.4

ALI (Acute Lung Injury) 13 0.7Haemothorax 12 0.6


Acute severe arrhythmia: tachycardias 110 5.9Acute severe arrhythmia: bradycardias 42 2.2

Pulmonary edema 42 2.2Left heart failure w/o pulm. edema 31 1.7

Neurological 105 5.6Drowsiness/agitation/delirium 61 3.3

Brain edema 23 1.2New ischaemic stroke 15 0.8

Seizures 14 0.7Intracranial hypertension 11 0.6

Gastrointestinal and hepatic 93 5.0Paralytic Ileous 25 1.3

Gastrointestinal bleeding: upper tract 16 0.9Liver Dysfunction Syndrome 16 0.9

Anastomotic dehiscence 12 0.6Bowel ischaemia 9 0.5

Other 83 4.4Metabolic disorder 37 2.0

Nephrourologic disease 30 1.6Other disease 12 0.6

Other skin and/or soft tissue pathology 7 0.4Graft vascular thrombosis 1 0.1

Iatrogenic major vessels injury 1 0.1- 0 0.0


L.R.T.I. other than pneumonia 30 1.6Gastroenteritis 25 1.3

Upper respiratory tract infection 17 0.9NON-surgical urinary tract infection 13 0.7

Catheter-related bacteremia (CR-BSI) 9 0.5Clinical sepsis 7 0.4

Other fungal infections 8 0.4Post-surgical peritonitis 7 0.4

NON-surgical secondary peritonitis 6 0.3Missing 5

PROSAFE project

Adult patients 28

National report for general ICUs - Year 2011Characteristics during the stay - Adult patients

Infections N %

None 980 52.3Only on admission 684 36.5

On admission and during ICU stay 73 3.9Only during ICU stay 138 7.4

Missing 5

Maximum severity of infection N %



Missing 5

Severity evolution During the stay

N (R %) NoneInfection with or

without SIRSSEVERESEPSIS

SEPTICSHOCK

TOT

Adm

issi

on

None 980 (87.7%) 116 (10.4%) 12 (1.1%) 10 (0.9%) 1118

Infection with or without SIRS - 363 (91.9%) 19 (4.8%) 13 (3.3%) 395

SEVERE SEPSIS - - 131 (82.9%) 27 (17.1%) 158

SEPTIC SHOCK - - - 204 (100.0%) 204

TOT 980 479 162 254 1875

Ventil. Associat. Pneumonia (VAP) N %

No 1809 96.2Yes 71 3.8

Missing 0

Incidence of VAP(Pts. with VAP/1000 days of VM pre-VAP)

Estimate 10.8CI (95%) 7.5-14.6

Incidence of VAP(Pts. with VAP/pts. ventilated for 8 days)

Estimate 8.6%CI (95%) 6.0-11.7

Catheter Bacteraemia (CR-BSI) N %

No 1866 99.5Yes 9 0.5

Missing 5

Incidence of CR-BSI(Pts. with CR-BSI/1000 days of CVC pre-CR-BSI)

Estimate 0.9CI (95%) 0.3-1.9

Incidence of CR-BSI(Pts. with CR-BSI/pts. catheterized for 12 days)

Estimate 1.1%CI (95%) 0.3-2.3

PROSAFE project

29 Adult patients

Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=5)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)18

1096

.5In

vasi

veve

ntila

tion

1349

71.9

907

48.4

267

14.2

31-

60

00-

00

Non

inva

sive

vent

ilatio

n36

619

.566

3.5

226

12.1

10-

20

21-

30

Trac

heos

tom

y26

113

.922

1.2

176

9.4

73-

140

75-

100

iNO

(inha

led

nitr

icox

ide)

00.

0C

entra

lVen

ous

Cat

hete

r11

8863

.438

720

.673

939

.46

3-10

00

0-0

0A

rter

ialC

athe

ter

1252

66.8

536

28.6

499

26.6

42-

80

00-

00

Vaso

activ

edr

ugs

649

34.6

239

12.7

144

7.7

21-

40

00-

10

Ant

iarr

hyth

mic

s29

815

.961

3.3

146

7.8

21-

50

10-

20

IAB

P2

0.1

10.

10

04

3-4

00

0-0

0In

vasi

vem

onito

ring

ofC

.O.

884.

78

0.4

100.

55

3-8

00

0-1

0C

ontin

ous

mon

itorin

gof

ScV

O2

160.

93

0.2

20.

14

1-14

00

0-0

0Te

mpo

rary

paci

ng24

1.3

60.

318

13

2-6

00

0-0

0Ve

ntric

ular

assi

stan

ce2

0.1

20.

11

0.1

22-

20

DC

-sho

ck58

3.1

10-

40

CP

R17

39.

21

0-7

0M

assi

vebl

ood

trans

fusi

on55

2.9

00-

00

Intra

cran

ialp

ress

ure

50.

34

0.2

20.

15

4-7

00

0-0

0In

trave

ntric

ular

devi

ce45

2.4

321.

712

0.6

63-

80

00-

00

Hae

mofi

ltrat

ion

140.

73

0.2

50.

31

0-8

00

0-1

0H

aem

odia

lysi

s96

5.1

251.

332

1.7

42-

80

11-

40

EC

MO

00.

0H

epat

iccl

eara

nce

tech

niqu

es0

0.0

Cle

aran

cete

chni

ques

durin

gse

psis

10.

10

00

00

0-0

06

6-6

0IA

P(in

tra-a

bdom

inal

pres

sure

)4

0.2

Hyp

othe

rmia

241.

3E

nter

alnu

triti

on13

4371

.629

815

.910

7257

.24

2-8

01

0-1

0P

aren

tera

lnut

ritio

n39

421

.058

3.1

134

7.1

42-

70

10-

10

SD

D(T

opic

al,T

opic

alan

dsy

stem

ic)

10.

1P

atie

ntre

stra

int

201.

1Va

cuum

ther

apy

00.

0A

ntib

iotic

s12

4266

.2A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

402

21.4

270

14.4

140

7.5

20-

50

00-

00

Ant

ibio

tics

form

edic

alpr

ophy

laxi

s84

4.5

321.

737

23

2-6

01

0-2

0E

mpi

rical

antib

iotic

ther

apy

770

41.1

358

19.1

376

20.1

42-

70

00-

10

Targ

eted

antib

iotic

ther

apy

318

17.0

482.

622

011

.76

4-11

05

2-7

0

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltpa

tient

s

PROSAFE project

Adult patients 30

National report for general ICUs - Year 2011Process indicators - Adult patients

Length (days)Invasive ventilation (N=1349) N % Mean SD Median Q1-Q3 Missing

Due to pulmonary failure 625 46.3 6.5 9.1 4 2-8 0For airway mainteinance 354 26.2 5.5 9.1 3 1-7 0

In weaning 67 5.0 0.8 0.4 1 1-1 0Not evaluable 303 22.5 4.0 6.4 2 2-4 0

Reintubation within 48 hours 25 1.9 5.5 5.8 5 1-6 0

Non invasive ventilation (N=366) N %

Non invasive ventilation only 91 24.9Non invasive ventilation failed 31 8.5

For weaning 243 66.4Other 1 0.3

Missing 0

Tracheostomy (N=261) N %

Surgical 22 8.4Ciaglia 35 13.4

Monodil. Ciaglia 24 9.2Fantoni 3 1.1Griggs 116 44.4

Percutwist 17 6.5Other Kind 44 16.9

Missing 0

Tracheostomy - Days after the beginning of inv. vent.N 255

Mean 7.3SD 4.9

Median 7Q1-Q3 4-9.5

Invasive monitoring of C.O. (N=88) N %

Swan Ganz 0 0.0PICCO 88 100.0LIDCO 0 0.0

Vigileo-PRAM 0 0.0Other 0 0.0

Missing 0

SDD (N=1) N %

Topical 1 100.0Topical and systemic 0 0.0

Missing 0

Antibiotic therapyPts. infected in ICU only (N=138) N %

Only empirical 72 53.3Only targeted 24 17.8

Targeted after empirical 28 20.7Other 11 8.1

Missing 3

Surgical interventions N %

No 1766 94.2Yes 109 5.8

Missing 5

Number of surgical interventions N %

0 1766 94.21 86 4.62 16 0.93 6 0.3

>3 1 0.1Missing 5

Surgical interventionsDays from admission

Mean 9.9SD 10.9

Median 6Q1-Q3 3-12

Missing 0

Surgical interventions (top 10) N %

Gastrointestinal surgery 46 2.5Other surgery 17 0.9


Pancreatic surgery 10 0.5Nephro/Urological surgery 9 0.5

Biliary tract surgery 5 0.3Neurosurgery 6 0.3

Plastic surgery 3 0.2ENT surgery 4 0.2

Missing 5


No 1835 97.9Yes 40 2.1

Missing 5

Non surgical interventionsDays from admission

Mean 7.4SD 6.6

Median 4Q1-Q3 2-10.5

Missing 2


Interventional endoscopy 40 2.1Interventional radiology 6 0.3

Interventional cardiology 0 0.0Interventional neuroradiology 0 0.0

Missing 5

PROSAFE project

31 Adult patients

National report for general ICUs - Year 2011Outcome indicators - Adult patients

ICU outcome N %

Dead 461 24.6Transferred to same hospital 1277 68.1Transferred to other hospital 113 6.0

Discharged home 24 1.3Disch. terminally ill 0 0.0

Missing 5

Transferred to (N=1390) N %

Ward 893 64.2Other ICU 71 5.1

High dependency care unit 426 30.6Rehabilitation 0 0.0

Day hospital or Long-term care 0 0.0Missing 0

Reason of transfer toOther ICU (N=71) N %



Missing 0

Transferred toSame hospital (N=1277) N %




Transferred toOther hospital (N=113) N %




ICU mortality N %

Alive 1414 75.4Dead 461 24.6

Missing 5

Timing of ICU mortality (N=461) N %

Daytime (08:00AM - 07:59PM) 258 56.0Nigthtime (08:00PM - 07:59AM) 203 44.0

Weekdays (Monday - Friday) 341 74.0Weekend (Saturday - Sunday) 120 26.0

Missing 0

Hospital mortality * N %

Alive 1141 63.7Dead 651 36.3

Missing 7

Timing of hosp. mortality * (N=651) N %

In ICU 428 65.7Within 24 hours after ICU 22 3.4Within 48 hours after ICU 47 7.2Within 72 hours after ICU 60 9.2Within 96 hours after ICU 87 13.4

After more than 96 hours after ICU 136 20.9Missing 0

Timing of hosp. mortality (days from ICU disch.) *Discharged alive from ICU (N=223)

Mean 15.1SD 23.9


Missing 0

* Statistics computed on patients admitted in months with more than 90% of patients in status 4 (readmissions excluded) (N=1799).

PROSAFE project

Adult patients 32

National report for general ICUs - Year 2011Outcome indicators - Adult patients

Last hospital mortality * N %

Alive 1139 63.6Dead 653 36.4

Missing 7

Readmission from ward N %

No 1843 98.1Yes 36 1.9

Missing 1

Number of readmissions (N=36) N %

1 34 94.42 1 2.8

>2 1 2.8Missing 0

Timing of readmission (N=36) N %

Within 48 hours 7 22.6Within 72 hours 10 32.3Within 96 hours 12 38.7

After 96 hours 19 61.3Missing 5

Timing readmission (days)N 31

Mean 9.5SD 13.7

Median 6.2Q1-Q3 2.3-11.2

ICU stay (days)Mean 6.5


Missing 5

ICU stay (days)Alive (N=1414)

Mean 6.3SD 9.0

Median 3Q1-Q3 2-7

Missing 0

ICU stay (days)Dead (N=461)

Mean 7.2SD 11.6

Median 3Q1-Q3 1-9

Missing 0

Stay after ICU (days) *Alive (N=1370)

Mean 11.9SD 17.4

Median 7Q1-Q3 3-13

Missing 6

Hospital stay (days) *Mean 20.0

SD 23.3Median 14Q1-Q3 7-23

Missing 7

Hospital stay (days) *Alive (N=1141)

Mean 20.8SD 21.0

Median 14Q1-Q3 9-23

Missing 0

Hospital stay (days) *Dead (N=651)

Mean 18.7SD 26.9

Median 11Q1-Q3 4-22

Missing 0

* Statistics computed on patients admitted in months with more than 90% of patients in status 4 (readmissions excluded) (N=1799).

PROSAFE project

33 Adult patients

PROSAFE project

34

National report for general ICUs - Year 2011Characteristics on admission - Adult patients with LOS>=24 hours evaluated in the GiViTI model

Patients (N): 1612

Sex N %


Age (years) N %

17-45 223 13.846-65 648 40.266-75 412 25.6>75 329 20.4

Missing 0Mean 62.2

SD 15.3Median 64Q1-Q3 54-73

Min-Max 17-97




Missing 0




Missing 0

Comorbidities N %

No 208 12.9Yes 1404 87.1

Missing 0



NYHA class II-III 341 21.2Any tumour without metastasis 338 21.0

Cerebrovascular disease 276 17.1Moderate COPD 271 16.8

Diabetes Type II without insulin tr. 263 16.3Arrhythmia 210 13.0

Myocardial infarction 193 12.0Peptic ulcer disease 143 8.9

Missing 0



Missing 0



Missing 0








Missing 0










No 1184 73.4Yes 428 26.6

Missing 0

PROSAFE project

35 Adult patients (LOS>=24 hours)


Trauma N %

No 1432 88.8Yes 180 11.2


Surgical status N %



48.4%

31.0%

20.6%

Surgical status





Missing 0



Peripheral vascular surgery 55 11.0Nephro/Urological surgery 54 10.8

Abdominal vascular surgery 25 5.0Neurosurgery 13 2.6

Orthopaedic surgery 10 2.0Pancreatic surgery 9 1.8

ENT surgery 9 1.8Other surgery 9 1.8

Missing 0




Missing 0






Gynaecological surgery 8 2.4ENT surgery 7 2.1

Missing 0




Missing 0







Missing 30




PROSAFE project

Adult patients (LOS>=24 hours) 36











0 1 2 3 >3


0

20

40

60

80

100

29.4%24.5%

20.0%

12.7% 13.4%


No 474 29.4Yes 1138 70.6






A 150 9.3G 113 7.0

ABEG 108 6.7AG 64 4.0

E 65 4.0EG 61 3.8

BEG 53 3.3B 51 3.2

ABG 46 2.9AE 47 2.9

Missing 0




Missing 0






Missing 0






None 1069 66.3Mild 295 18.3



None 974 60.4pH <= 7.3, PaCO2 < 45 mmHg 249 15.4


PROSAFE project





Pneumothorax/Pneumomediastinum 100 6.2Pleural effusion 90 5.6

Lung cancer 85 5.3Acute exacerbation of COPD 78 4.8

Cardiovascular 444 27.5Left heart failure with pulmonary edema 110 6.8

Cardiac arrest 93 5.8Left heart failure without pulm. edema 81 5.0Acute severe arrhythmia: tachycardias 81 5.0

Acute myocardial infarction 81 5.0Neurological 195 12.1

Metabolic/postanoxic encephalopathy 65 4.0Cerebral artery stroke 49 3.0

Seizures 43 2.7Spontaneous Intraparenchymal bleeding 15 0.9

Polyneuropathy/myopathy 14 0.9Gastrointestinal and hepatic 253 15.7

Digestive tract malignancy 63 3.9Gastrointestinal bleeding: upper tract 32 2.0

Gastrointestinal perforation 29 1.8Acute pancreatitis 27 1.7

Liver Dysfunction Syndrome 24 1.5Trauma (anatomical districts) 180 11.2

Head 103 6.4Chest 73 4.5



- 0 0.0Other 418 25.9


Other disease 62 3.8Coagulation disorder 46 2.9


- 0 0.0- 0 0.0


L.R.T.I. other than pneumonia 86 5.3NON-surgical urinary tract infection 55 3.4NON-surgical secondary peritonitis 48 3.0

Post-surgical peritonitis 29 1.8Clinical sepsis 25 1.6

Primary peritonitis 25 1.6NON-surgical skin/soft tissue infection 25 1.6

Cholecystitis/cholangitis 23 1.4Gastroenteritis 23 1.4

Missing 0


Head 103 6.4Traumatic Subdural haemathoma 47 2.9

Skull fracture 47 2.9Traumatic subarachnoid haemorrhage 43 2.7

Cerebral contusion/laceration 42 2.6Traumatic Intraparenchimal bleeding 21 1.3



Traum. haemothorax/pneumothorax 53 3.3Severe lung contusion/laceration 30 1.9

Other injuries of the chest 30 1.9Abdomen 23 1.4


Minor injuries of the abdomen 6 0.4Pelvis/bone/joint & muscle 50 3.1



Major thoracic vessels: transection 3 0.2Aorta: rupture/dissection 4 0.2

Neck vessels: dissection/transection 1 0.1Miscellaneous 0 0.0

- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

53.2%

21.3%

25.5%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult patients with LOS>=24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

10

20

30

40

50

60






0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

SAPSIIMean 34.0

SD 19.5Median 30Q1-Q3 18-47


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

5

10

15

20

25

SOFAMean 4.2



PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult patients with LOS>=24 hours evaluated in the GiViTI model


No 947 58.7Yes 665 41.3

Missing 0


No 1345 83.4Yes 267 16.6






B 65 4.0A 43 2.7E 34 2.1

BE 13 0.8G 11 0.7

AB 10 0.6AE 8 0.5

BCE 8 0.5ABE 6 0.4

C 7 0.4Missing 0




Missing 0









Missing 0


None 1511 93.7Mild 20 1.2




Pneumothorax/Pneumomediastinum 34 2.1Atelectasis 26 1.6

ALI (Acute Lung Injury) 13 0.8Haemothorax 12 0.7

Cardiovascular 243 15.1Acute severe arrhythmia: tachycardias 100 6.2

Cardiac arrest 93 5.8Pulmonary edema 37 2.3

Acute severe arrhythmia: bradycardias 31 1.9Left heart failure w/o pulm. edema 25 1.6


Brain edema 18 1.1Seizures 13 0.8

New ischaemic stroke 12 0.7Intracranial hypertension 9 0.6


Liver Dysfunction Syndrome 15 0.9Gastrointestinal bleeding: upper tract 13 0.8

Anastomotic dehiscence 12 0.7Acute pancreatitis 8 0.5


Nephrourologic disease 27 1.7Other disease 11 0.7

Other skin and/or soft tissue pathology 6 0.4Graft vascular thrombosis 1 0.1

Iatrogenic major vessels injury 1 0.1- 0 0.0





Post-surgical peritonitis 6 0.4NON-surgical secondary peritonitis 6 0.4

Other fungal infections 5 0.3Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult patients with LOS>=24 hours evaluated in the GiViTI model

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 822 (86.6%) 107 (11.3%) 12 (1.3%) 8 (0.8%) 949


SEVERE SEPSIS - - 118 (83.7%) 23 (16.3%) 141

SEPTIC SHOCK - - - 169 (100.0%) 169

TOT 822 431 147 212 1612


No 1544 95.8Yes 68 4.2

Missing 0


Estimate 11.0CI (95%) 7.6-15.0


Estimate 8.8%CI (95%) 6.1-12.0


No 1606 99.6Yes 6 0.4

Missing 0


Estimate 0.6CI (95%) 0.1-1.6


Estimate 0.8%CI (95%) 0.2-1.9

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)15

5896

.7In

vasi

veve

ntila

tion

1149

71.3

782

48.5

213

13.2

32-

70

00-

00

Non

inva

sive

vent

ilatio

n34

621

.561

3.8

212

13.2

10-

20

21-

30

Trac

heos

tom

y24

215

.017

1.1

165

10.2

73-

140

75-

100

iNO

(inha

led

nitr

icox

ide)

00.

0C

entra

lVen

ous

Cat

hete

r10

3664

.333

720

.965

740

.86

3-11

00

0-0

0A

rter

ialC

athe

ter

1101

68.3

478

29.7

436

274

2-8

00

0-0

0Va

soac

tive

drug

s51

932

.218

511

.510

56.

53

1-5

00

0-1

0A

ntia

rrhy

thm

ics

257

15.9

533.

313

68.

43

1-5

01

0-2

0IA

BP

20.

11

0.1

00

43-

40

00-

00

Inva

sive

mon

itorin

gof

C.O

.80

5.0

80.

59

0.6

53-

90

00-

10

Con

tinou

sm

onito

ring

ofS

cVO

214

0.9

30.

22

0.1

52-

140

00-

00

Tem

pora

rypa

cing

201.

24

0.2

150.

94

3-7

00

0-0

0Ve

ntric

ular

assi

stan

ce2

0.1

20.

11

0.1

22-

20

DC

-sho

ck40

2.5

20-

70

CP

R11

57.

13

0-8

0M

assi

vebl

ood

trans

fusi

on45

2.8

00-

00

Intra

cran

ialp

ress

ure

40.

23

0.2

10.

16

5-8

00

0-0

0In

trave

ntric

ular

devi

ce38

2.4

291.

811

0.7

64-

90

00-

00

Hae

mofi

ltrat

ion

110.

72

0.1

40.

21

0-7

00

0-1

0H

aem

odia

lysi

s90

5.6

241.

531

1.9

42-

80

11-

30

EC

MO

00.

0H

epat

iccl

eara

nce

tech

niqu

es0

0.0

Cle

aran

cete

chni

ques

durin

gse

psis

10.

10

00

00

0-0

06

6-6

0IA

P(in

tra-a

bdom

inal

pres

sure

)4

0.2

Hyp

othe

rmia

140.

9E

nter

alnu

triti

on12

5477

.827

417

1010

62.7

42-

80

10-

10

Par

ente

raln

utrit

ion

359

22.3

523.

212

47.

74

2-7

01

0-1

0S

DD

(Top

ical

,Top

ical

and

syst

emic

)1

0.1

Pat

ient

rest

rain

t17

1.1

Vacu

umth

erap

y0

0.0

Ant

ibio

tics

1112

69A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

355

22.0

245

15.2

125

7.8

20-

60

00-

00

Ant

ibio

tics

form

edic

alpr

ophy

laxi

s80

5.0

301.

935

2.2

32-

60

10-

30

Em

piric

alan

tibio

ticth

erap

y69

242

.932

220

342

21.2

43-

70

00-

10

Targ

eted

antib

iotic

ther

apy

294

18.2

442.

720

512

.76

4-11

05

2-7

0

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltpa

tient

sw

ithLO

S>=

24ho

urs

eval

uate

din

the

GiV

iTIm

odel

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult patients with LOS>=24 hours evaluated in the GiViTI model


Due to pulmonary failure 520 45.3 7.2 9.3 4 2-9 0For airway mainteinance 287 25.0 6.0 7.9 4 1.5-8 0


Reintubation within 48 hours 24 2.1 5.5 6.0 4.5 1-6.5 0




Missing 0





Missing 0


Mean 7.3SD 4.7

Median 7Q1-Q3 4-9




Missing 0

SDD (N=1) N %


Missing 0




Missing 2


No 1512 93.8Yes 100 6.2

Missing 0


0 1512 93.81 81 5.02 14 0.93 5 0.3

>3 0 0.0Missing 0


Mean 9.2SD 9.8

Median 6Q1-Q3 3-11

Missing 0




Thoracic surgery 8 0.5Nephro/Urological surgery 7 0.4

Neurosurgery 6 0.4Biliary tract surgery 5 0.3

Plastic surgery 3 0.2ENT surgery 3 0.2

Missing 0


No 1576 97.8Yes 36 2.2

Missing 0


Mean 7.6SD 6.8

Median 4Q1-Q3 2.8-11

Missing 2




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult patients with LOS>=24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 1286 79.8Dead 326 20.2

Missing 0




Missing 0

Hospital mortality N %

Alive 1074 66.6Dead 538 33.4

Missing 0

Timing of hosp. mortality (N=538) N %



Timing of hosp. mortality (days from ICU disch.)Discharged alive from ICU (N=212)

Mean 15.3SD 24.1

Median 6Q1-Q3 2-19

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult patients with LOS>=24 hours evaluated in the GiViTI model

Last hospital mortality N %

Alive 1073 66.6Dead 539 33.4

Missing 0



Missing 0


Mean 6.5SD 8.9

Median 3Q1-Q3 2-7

Missing 0


Mean 8.8SD 12.0

Median 5Q1-Q3 2-11

Missing 0

Stay after ICU (days)Alive (N=1286)

Mean 12.1SD 17.7

Median 7Q1-Q3 3-13

Missing 0

Hospital stay (days)Mean 21.2

SD 23.1Median 14Q1-Q3 8-24

Missing 0

Hospital stay (days)Alive (N=1074)

Mean 21.4SD 21.3


Missing 0

Hospital stay (days)Dead (N=538)

Mean 20.6SD 26.2

Median 13Q1-Q3 6-24

Missing 0

PROSAFE project


PROSAFE project

46

National report for general ICUs - Year 2011Characteristics on admission - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model

Patients (N): 781

Sex N %


Age (years) N %

17-45 131 16.846-65 264 33.866-75 196 25.1>75 190 24.3

Missing 0Mean 62.5

SD 16.7Median 65Q1-Q3 53-75

Min-Max 17-96




Missing 0




Missing 0

Comorbidities N %

No 106 13.6Yes 675 86.4

Missing 0


Hypertension 492 63.0NYHA class II-III 183 23.4

Peripheral vascular disease 180 23.0Cerebrovascular disease 143 18.3

Diabetes Type II without insulin tr. 139 17.8Myocardial infarction 123 15.7

Arrhythmia 118 15.1Moderate COPD 109 14.0

NYHA class IV 84 10.8Severe COPD 67 8.6

Missing 0



Missing 0



Missing 0








Missing 0










No 779 99.7Yes 2 0.3

Missing 0

PROSAFE project

47 Non surgical (LOS>=24 hours)


Trauma N %

No 721 92.3Yes 60 7.7


Surgical status N %



100.0%

0.0%0.0%

Surgical status





Missing 0


- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0


- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0







Missing 0




PROSAFE project

Non surgical (LOS>=24 hours) 48











0 1 2 3 >3


0

20

40

60

80

100

16.8%23.7% 24.5%

16.5% 18.6%


No 131 16.8Yes 650 83.2






A 97 12.4ABEG 67 8.6

AG 44 5.6AE 38 4.9

AEG 32 4.1B 29 3.7

BEG 29 3.7E 28 3.6

ABG 27 3.5EG 27 3.5

Missing 0




Missing 0






Missing 0






None 441 56.5Mild 175 22.4



None 445 57.0pH <= 7.3, PaCO2 < 45 mmHg 115 14.7


PROSAFE project




Respiratory 223 28.6Acute exacerbation of COPD 67 8.6

Pleural effusion 56 7.2Pulmonary embolism 40 5.1

Pneumothorax/Pneumomediastinum 20 2.6Aspiration pneumonia 19 2.4

Cardiovascular 306 39.2Left heart failure with pulmonary edema 96 12.3

Cardiac arrest 86 11.0Acute myocardial infarction 75 9.6

Left heart failure without pulm. edema 59 7.6Acute severe arrhythmia: tachycardias 56 7.2

Neurological 149 19.1Metabolic/postanoxic encephalopathy 56 7.2

Cerebral artery stroke 36 4.6Seizures 36 4.6

Polyneuropathy/myopathy 12 1.5Spontaneous Intraparenchymal bleeding 11 1.4

Gastrointestinal and hepatic 81 10.4Acute pancreatitis 19 2.4

Liver Dysfunction Syndrome 17 2.2Gastrointestinal bleeding: upper tract 16 2.0

Ascites 15 1.9Acute on chronic liver disease 8 1.0

Trauma (anatomical districts) 60 7.7Head 32 4.1Chest 30 3.8Spine 14 1.8

Pelvis/bone/joint & muscle 12 1.5Abdomen 6 0.8

Major vessels injury 3 0.4- 0 0.0


Nephrourologic disease 49 6.3Acute intoxication 38 4.9

Coagulation disorder 28 3.6Haematological disease 16 2.0Post transplantation 0 0.0

- 0 0.0- 0 0.0


L.R.T.I. other than pneumonia 66 8.5NON-surgical urinary tract infection 42 5.4

Gastroenteritis 20 2.6Clinical sepsis 17 2.2

NON-surgical skin/soft tissue infection 13 1.7Upper respiratory tract infection 13 1.7

NON-surgical CNS infection 11 1.4Cholecystitis/cholangitis 8 1.0

Pleurisy/Pleural empyema 7 0.9Missing 0


Head 32 4.1Traumatic subarachnoid haemorrhage 15 1.9

Skull fracture 12 1.5Cerebral contusion/laceration 11 1.4

Traumatic Subdural haemathoma 8 1.0Traumatic Intraparenchimal bleeding 8 1.0

Spine 14 1.8Vertebral fracture, without deficit 9 1.2

Tetraplegia 2 0.3Paraplegia 2 0.3

Chest 30 3.8Traum. haemothorax/pneumothorax 20 2.6

Severe lung contusion/laceration 12 1.5Other injuries of the chest 12 1.5

Abdomen 6 0.8Minor injuries of the abdomen 2 0.3Bowel transection/perforation 1 0.1

Liver: Moderate-Severe laceration 1 0.1Pelvis/bone/joint & muscle 12 1.5


Massive crush/amputation 1 0.1Major vessels injury 3 0.4Aorta: rupture/dissection 3 0.4

- 0 0.0- 0 0.0

Miscellaneous 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

58.7%19.7%

21.6%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

10

20

30

40


Median 14Q1-Q3 9-15




0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

SAPSIIMean 42.7

SD 19.8Median 41Q1-Q3 28-55.8


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

5

10

15

SOFAMean 5.7



PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model


No 408 52.2Yes 373 47.8

Missing 0


No 612 78.4Yes 169 21.6






B 44 5.6A 31 4.0E 18 2.3

BE 12 1.5G 8 1.0

AE 7 0.9AB 6 0.8

C 4 0.5D 4 0.5

AC 3 0.4Missing 0




Missing 0









Missing 0


None 721 92.3Mild 12 1.5




Pneumothorax/Pneumomediastinum 21 2.7ALI (Acute Lung Injury) 12 1.5

ARDS 7 0.9Atelectasis 6 0.8


Acute severe arrhythmia: tachycardias 49 6.3Pulmonary edema 26 3.3

Acute severe arrhythmia: bradycardias 22 2.8Left heart failure w/o pulm. edema 17 2.2


Seizures 9 1.2Brain edema 8 1.0

New ischaemic stroke 6 0.8CrIMyNe 3 0.4


Gastrointestinal bleeding: upper tract 10 1.3Liver Dysfunction Syndrome 7 0.9

Acute pancreatitis 4 0.5Acute bile-duct disease 3 0.4

Other 38 4.9Nephrourologic disease 18 2.3

Metabolic disorder 16 2.0Other disease 3 0.4

Other skin and/or soft tissue pathology 3 0.4Iatrogenic major vessels injury 1 0.1

- 0 0.0- 0 0.0





Other fungal infections 3 0.4NON-surgical secondary peritonitis 2 0.3

NON-surgical skin/soft tissue infection 2 0.3Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 289 (82.6%) 54 (15.4%) 5 (1.4%) 2 (0.6%) 350


SEVERE SEPSIS - - 71 (83.5%) 14 (16.5%) 85

SEPTIC SHOCK - - - 93 (100.0%) 93

TOT 289 285 88 119 781


No 746 95.5Yes 35 4.5

Missing 0


Estimate 9.4CI (95%) 5.5-14.2


Estimate 7.5%CI (95%) 4.4-11.4


No 778 99.6Yes 3 0.4

Missing 0


Estimate 0.5CI (95%) 0.0-1.6


Estimate 0.6%CI (95%) 0.0-1.9

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)76

798

.2In

vasi

veve

ntila

tion

566

72.5

334

42.8

128

16.4

42-

90

00-

00

Non

inva

sive

vent

ilatio

n15

720

.149

6.3

709

10-

20

20-

60

Trac

heos

tom

y16

220

.79

1.2

106

13.6

83-

140

74-

100

iNO

(inha

led

nitr

icox

ide)

00.

0C

entra

lVen

ous

Cat

hete

r59

876

.619

124

.535

946

63-

110

00-

00

Art

eria

lCat

hete

r59

275

.822

028

.221

127

53-

90

00-

00

Vaso

activ

edr

ugs

304

38.9

108

13.8

587.

43

1-5

00

0-1

0A

ntia

rrhy

thm

ics

158

20.2

395

8310

.63

2-7

01

0-2

0IA

BP

20.

31

0.1

00

43-

40

00-

00

Inva

sive

mon

itorin

gof

C.O

.41

5.2

40.

55

0.6

53-

90

00-

10

Con

tinou

sm

onito

ring

ofS

cVO

27

0.9

10.

11

0.1

42-

120

00-

00

Tem

pora

rypa

cing

182.

33

0.4

141.

84

3-7

00

0-0

0Ve

ntric

ular

assi

stan

ce1

0.1

10.

11

0.1

11-

10

DC

-sho

ck32

4.1

20-

40

CP

R88

11.3

20-

70

Mas

sive

bloo

dtra

nsfu

sion

70.

90

0-0

0In

tracr

ania

lpre

ssur

e0

0.0

Intra

vent

ricul

arde

vice

10.

11

0.1

10.

13

3-3

0H

aem

ofiltr

atio

n9

1.2

20.

33

0.4

10-

90

00-

00

Hae

mod

ialy

sis

668.

520

2.6

212.

74

2-8

01

0-4

0E

CM

O0

0.0

Hep

atic

clea

ranc

ete

chni

ques

00.

0C

lear

ance

tech

niqu

esdu

ring

seps

is0

0.0

IAP

(intra

-abd

omin

alpr

essu

re)

20.

3H

ypot

herm

ia12

1.5

Ent

eral

nutr

ition

662

84.8

187

23.9

504

64.5

53-

90

10-

10

Par

ente

raln

utrit

ion

135

17.3

192.

426

3.3

42-

100

00-

10

SD

D(T

opic

al,T

opic

alan

dsy

stem

ic)

10.

1P

atie

ntre

stra

int

101.

3Va

cuum

ther

apy

00.

0A

ntib

iotic

s54

870

.2A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

222.

87

0.9

60.

86

4-14

00

0-2

0A

ntib

iotic

sfo

rmed

ical

prop

hyla

xis

587.

423

2.9

263.

34

2-7

01

0-4

0E

mpi

rical

antib

iotic

ther

apy

446

57.1

225

28.8

203

265

3-7

00

0-1

0Ta

rget

edan

tibio

ticth

erap

y18

824

.127

3.5

122

15.6

74-

120

52-

70

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltno

nsu

rgic

alpa

tient

sw

ithLO

S>=

24ho

urs

eval

uate

din

the

GiV

iTIm

odel

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model


Due to pulmonary failure 368 64.9 7.5 9.7 4 2-9 0For airway mainteinance 143 25.2 5.9 7.4 3 1.5-7 0

In weaning 5 0.9 0.8 0.4 1 1-1 0Not evaluable 51 9.0 9.5 13.0 6 3-9.5 0

Reintubation within 48 hours 14 2.5 5.9 6.5 4.5 1.25-7.5 0




Missing 0





Missing 0


Mean 7.2SD 4.8

Median 7Q1-Q3 4-9




Missing 0

SDD (N=1) N %


Missing 0




Missing 0


No 738 94.5Yes 43 5.5

Missing 0


0 738 94.51 33 4.22 7 0.93 3 0.4

>3 0 0.0Missing 0


Mean 11.8SD 11.8

Median 8Q1-Q3 3-15

Missing 0



Pancreatic surgery 6 0.8Biliary tract surgery 5 0.6

Orthopaedic surgery 4 0.5Nephro/Urological surgery 3 0.4

Plastic surgery 2 0.3Abdominal vascular surgery 2 0.3

Splenectomy 2 0.3Hepatic surgery 1 0.1

Missing 0


No 758 97.1Yes 23 2.9

Missing 0


Mean 5.5SD 4.8

Median 3Q1-Q3 2.5-7.5

Missing 1




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 579 74.1Dead 202 25.9

Missing 0




Missing 0


Alive 452 57.9Dead 329 42.1

Missing 0





Mean 10.3SD 15.0


Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult non surgical patients with LOS>=24 hours evaluated in the GiViTI model


Alive 452 57.9Dead 329 42.1

Missing 0



Missing 0


Mean 7.9SD 9.3

Median 5Q1-Q3 3-9

Missing 0


Mean 9.8SD 14.2

Median 5Q1-Q3 2-11

Missing 0


Mean 11.4SD 15.6

Median 7Q1-Q3 1-14

Missing 0


SD 21.6Median 14Q1-Q3 7-24

Missing 0


Mean 21.5SD 21.1

Median 15Q1-Q3 9-27

Missing 0


Mean 18.5SD 22.2

Median 12Q1-Q3 5-23

Missing 0

PROSAFE project


PROSAFE project

58

National report for general ICUs - Year 2011Characteristics on admission - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model

Patients (N): 499

Sex N %


Age (years) N %

17-45 36 7.246-65 264 52.966-75 139 27.9>75 60 12.0

Missing 0Mean 62.1

SD 11.5Median 63Q1-Q3 55-70

Min-Max 20-88




Missing 0




Missing 0

Comorbidities N %

No 31 6.2Yes 468 93.8

Missing 0


Hypertension 321 64.3Any tumour without metastasis 246 49.3

Peripheral vascular disease 145 29.1Moderate COPD 112 22.4

Cerebrovascular disease 91 18.2NYHA class II-III 91 18.2

Diabetes Type II without insulin tr. 75 15.0Peptic ulcer disease 55 11.0

Arrhythmia 49 9.8Myocardial infarction 43 8.6

Missing 0



Missing 0



Missing 0








Missing 0










No 73 14.6Yes 426 85.4

Missing 0

PROSAFE project

59 Elective surgical (LOS>=24 hours)


Trauma N %

No 484 97.0Yes 15 3.0


Surgical status N %



0.0%

100.0%

0.0%

Surgical status





Missing 0



Peripheral vascular surgery 55 11.0Nephro/Urological surgery 54 10.8

Abdominal vascular surgery 25 5.0Neurosurgery 13 2.6


ENT surgery 9 1.8Other surgery 9 1.8

Missing 0




Missing 0


- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0





Interventional radiology 0 0.0Interventional cardiology 0 0.0

Interventional neuroradiology 0 0.0Interventional endoscopy 0 0.0

Missing 30




PROSAFE project

Elective surgical (LOS>=24 hours) 60











0 1 2 3 >3


0

20

40

60

80

100

57.9%

26.1%

11.0%

2.8% 2.2%


No 289 57.9Yes 210 42.1






G 81 16.2EG 26 5.2

E 25 5.0A 15 3.0

BG 9 1.8B 6 1.2

BEG 6 1.2BE 5 1.0AE 4 0.8AB 3 0.6

Missing 0




Missing 0






Missing 0






None 422 84.6Mild 60 12.0



None 357 71.5pH <= 7.3, PaCO2 < 45 mmHg 85 17.0


PROSAFE project





Lung cancer 80 16.0Pneumothorax/Pneumomediastinum 74 14.8

Haemothorax (non traumatic) 43 8.6Pleural effusion 22 4.4

Cardiovascular 83 16.6Peripheral vascular disease 27 5.4

Acute severe arrhythmia: tachycardias 15 3.0Non-ruptured aneurysm 10 2.0

Left heart failure without pulm. edema 9 1.8Systemic hypertensive crisis 7 1.4

Neurological 20 4.0Cerebral artery stroke 6 1.2

Metabolic/postanoxic encephalopathy 3 0.6Vertebral basilar ischemic stroke 2 0.4

Seizures 2 0.4Brain tumour 2 0.4


Pancreatic malignancy 8 1.6Intrabdominal bleeding (non traumatic) 5 1.0

Anastomotic dehiscence 4 0.8Paralytic Ileus 3 0.6

Trauma (anatomical districts) 15 3.0Head 6 1.2Spine 5 1.0

Pelvis/bone/joint & muscle 4 0.8Chest 2 0.4

Major vessels injury 2 0.4- 0 0.0- 0 0.0

Other 111 22.2Other disease 43 8.6

Nephrourologic disease 31 6.2Metabolic disorder 21 4.2

Coagulation disorder 9 1.8Haematological disease 4 0.8Post transplantation 0 0.0

- 0 0.0- 0 0.0

Infections 63 12.6L.R.T.I. other than pneumonia 13 2.6

Pneumonia 13 2.6Pleurisy/Pleural empyema 9 1.8

Post-surgical peritonitis 7 1.4NON-surgical urinary tract infection 4 0.8

Clinical sepsis 3 0.6Upper respiratory tract infection 3 0.6

Post-surgical urinary tract infection 3 0.6NON-surgical endocarditis 2 0.4

NON-surgical secondary peritonitis 2 0.4Missing 0


Head 6 1.2Cerebral contusion/laceration 3 0.6

Traumatic Subdural haemathoma 2 0.4Traumatic subarachnoid haemorrhage 2 0.4

Maxillofacial fracture 2 0.4Traumatic Intraparenchimal bleeding 1 0.2


Dorsal injury, incomplete deficit 1 0.2Chest 2 0.4

Flail chest 2 0.4Traum. haemothorax/pneumothorax 1 0.2

Traumatic Massive haemothorax 1 0.2Abdomen 0 0.0

- 0 0.0- 0 0.0- 0 0.0

Pelvis/bone/joint & muscle 4 0.8Long bones fracture 4 0.8

Multiple fracture of the pelvis 1 0.2- 0 0.0

Major vessels injury 2 0.4Major thoracic vessels: transection 2 0.4

- 0 0.0- 0 0.0

Miscellaneous 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

63.5%

20.6%

15.9%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

20

40

60

80

100

On admissionWorst value in the first 24 hours GCS (admission)





0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

20

25

30

SAPSIIMean 21.7

SD 11.7Median 20Q1-Q3 13-28


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

10

20

30

40

SOFAMean 1.9



PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model


No 377 75.6Yes 122 24.4

Missing 0


No 466 93.4Yes 33 6.6






A 7 1.4B 7 1.4E 5 1.0

BG 3 0.6BCE 2 0.4

AB 1 0.2ABE 1 0.2

AE 1 0.2BC 1 0.2BE 1 0.2

Missing 0




Missing 0









Missing 0


None 488 97.8Mild 4 0.8




Atelectasis 13 2.6Haemothorax 10 2.0

Pneumothorax/Pneumomediastinum 8 1.6Acute asthma/bronchospasm 3 0.6


Cardiac arrest 8 1.6Pulmonary edema 6 1.2

Acute myocardial infarction 3 0.6Acute severe arrhythmia: bradycardias 2 0.4


Brain edema 3 0.6New ischaemic stroke 1 0.2

Seizures 1 0.2- 0 0.0

Gastrointestinal and hepatic 15 3.0Anastomotic dehiscence 5 1.0

Bowel ischaemia 3 0.6Paralytic Ileous 3 0.6

Retroperitoneal bleeding 3 0.6Acute pancreatitis 2 0.4


Other disease 4 0.8Nephrourologic disease 2 0.4

Graft vascular thrombosis 1 0.2- 0 0.0- 0 0.0- 0 0.0


Gastroenteritis 4 0.8L.R.T.I. other than pneumonia 4 0.8

Post-surgical peritonitis 4 0.8Upper respiratory tract infection 3 0.6

Primary peritonitis 2 0.4Catheter-related bacteremia (CR-BSI) 1 0.2

NON-surgical mediastinitis 1 0.2Post-surgical mediastinitis 1 0.2Pleurisy/Pleural empyema 1 0.2

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 402 (92.2%) 25 (5.7%) 4 (0.9%) 5 (1.1%) 436


SEVERE SEPSIS - - 12 (92.3%) 1 (7.7%) 13

SEPTIC SHOCK - - - 10 (100.0%) 10

TOT 402 62 18 17 499


No 487 97.6Yes 12 2.4

Missing 0


Estimate 13.1CI (95%) 4.8-25.4


Estimate 10.5%CI (95%) 3.8-20.4


No 498 99.8Yes 1 0.2

Missing 0


Estimate 0.9CI (95%) 0.0-4.3


Estimate 1.0%CI (95%) 0.0-5.2

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)46

593

.2In

vasi

veve

ntila

tion

300

60.1

236

47.3

316.

22

2-2

00

0-0

0N

onin

vasi

veve

ntila

tion

139

27.9

81.

611

623

.20

0-1

02

2-2

0Tr

ache

osto

my

214.

26

1.2

163.

26

2-13

08

5-10

0iN

O(in

hale

dni

tric

oxid

e)0

0.0

Cen

tralV

enou

sC

athe

ter

164

32.9

6412

.811

723

.45

2-8

00

0-0

0A

rter

ialC

athe

ter

238

47.7

152

30.5

136

27.3

22-

40

00-

00

Vaso

activ

edr

ugs

5310

.613

2.6

112.

22

1-5

00

0-1

0A

ntia

rrhy

thm

ics

5210

.48

1.6

275.

42

1-4

01

0-2

0IA

BP

00.

0In

vasi

vem

onito

ring

ofC

.O.

122.

41

0.2

10.

23

3-8

00

0-2

0C

ontin

ous

mon

itorin

gof

ScV

O2

10.

20

00

014

14-1

40

00-

00

Tem

pora

rypa

cing

00.

0Ve

ntric

ular

assi

stan

ce0

0.0

DC

-sho

ck4

0.8

117-

130

CP

R7

1.4

139-

140

Mas

sive

bloo

dtra

nsfu

sion

102.

00

0-1

0In

tracr

ania

lpre

ssur

e1

0.2

10.

21

0.2

55-

50

Intra

vent

ricul

arde

vice

10.

21

0.2

10.

25

5-5

0H

aem

ofiltr

atio

n1

0.2

00

00

00-

00

11-

10

Hae

mod

ialy

sis

40.

81

0.2

30.

66

3-8

03

2-3

0E

CM

O0

0.0

Hep

atic

clea

ranc

ete

chni

ques

00.

0C

lear

ance

tech

niqu

esdu

ring

seps

is1

0.2

00

00

00-

00

66-

60

IAP

(intra

-abd

omin

alpr

essu

re)

10.

2H

ypot

herm

ia0

0.0

Ent

eral

nutr

ition

354

70.9

6212

.430

861

.72

2-3

00

0-1

0P

aren

tera

lnut

ritio

n96

19.2

193.

845

93

2-6

01

0-1

0S

DD

(Top

ical

,Top

ical

and

syst

emic

)0

0.0

Pat

ient

rest

rain

t6

1.2

Vacu

umth

erap

y0

0.0

Ant

ibio

tics

269

53.9

Ant

ibio

tics

fors

urgi

calp

roph

ylax

is19

539

.113

426

.938

7.6

00-

30

00-

00

Ant

ibio

tics

form

edic

alpr

ophy

laxi

s10

2.0

20.

44

0.8

21-

60

21-

30

Em

piric

alan

tibio

ticth

erap

y78

15.6

214.

249

9.8

42-

70

20-

40

Targ

eted

antib

iotic

ther

apy

336.

66

1.2

255

42-

50

52-

60

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltel

ectiv

esu

rgic

alpa

tient

sw

ithLO

S>=

24ho

urs

eval

uate

din

the

GiV

iTIm

odel

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model


Due to pulmonary failure 38 12.7 6.7 10.6 3 2-8.5 0For airway mainteinance 28 9.4 7.3 15.9 2 1-8 0


Reintubation within 48 hours 1 0.3 6.0 6 6-6 0




Missing 0





Missing 0


Mean 6.3SD 6.2

Median 6Q1-Q3 0-9




Missing 0

SDD (N=0) N %


Missing 0




Missing 0


No 483 96.8Yes 16 3.2

Missing 0


0 483 96.81 13 2.62 2 0.43 1 0.2

>3 0 0.0Missing 0


Mean 9.4SD 12.3

Median 6Q1-Q3 3.8-9.5

Missing 0


Gastrointestinal surgery 7 1.4Thoracic surgery 6 1.2


Plastic surgery 1 0.2Peripheral vascular surgery 1 0.2

- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0


No 492 98.6Yes 7 1.4

Missing 0


Mean 7.7SD 6.8

Median 5Q1-Q3 2.2-12.2

Missing 1




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 472 94.6Dead 27 5.4

Missing 0




Missing 0


Alive 439 88.0Dead 60 12.0

Missing 0





Mean 27.0SD 36.7

Median 14Q1-Q3 7-29

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult elective surgical patients with LOS>=24 hours evaluated in the GiViTI model


Alive 438 87.8Dead 61 12.2

Missing 0



Missing 0


Mean 3.9SD 7.6

Median 2Q1-Q3 2-4

Missing 0


Mean 7.1SD 5.2

Median 5Q1-Q3 3-9

Missing 0


Mean 10.3SD 15.1

Median 6Q1-Q3 4-11

Missing 0


SD 19.6Median 14Q1-Q3 10-21

Missing 0


Mean 17.9SD 15.2

Median 14Q1-Q3 10-20.5

Missing 0


Mean 30.9SD 37.2

Median 19Q1-Q3 12.8-33.2

Missing 0

PROSAFE project


PROSAFE project

70

National report for general ICUs - Year 2011Characteristics on admission - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTImodel

Patients (N): 332

Sex N %


Age (years) N %

17-45 56 16.946-65 120 36.166-75 77 23.2>75 79 23.8

Missing 0Mean 61.9

SD 16.8Median 64Q1-Q3 52-75

Min-Max 18-97




Missing 0




Missing 0

Comorbidities N %

No 71 21.4Yes 261 78.6

Missing 0


Hypertension 196 59.0NYHA class II-III 67 20.2

Peripheral vascular disease 65 19.6Moderate COPD 50 15.1

Diabetes Type II without insulin tr. 49 14.8Arrhythmia 43 13.0

Cerebrovascular disease 42 12.7Peptic ulcer disease 31 9.3

Any tumour without metastasis 28 8.4Myocardial infarction 27 8.1

Missing 0



Missing 0



Missing 0








Missing 0










No 332 100.0Yes 0 0.0

Missing 0

PROSAFE project

71 Emergency surgical (LOS>=24 hours)


Trauma N %

No 227 68.4Yes 105 31.6


Surgical status N %



0.0%0.0%

100.0%

Surgical status





Missing 0


- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0







Missing 0




Missing 0





Interventional neuroradiology 1 100.0Interventional radiology 0 0.0

Interventional cardiology 0 0.0Interventional endoscopy 0 0.0

Missing 0




PROSAFE project

Emergency surgical (LOS>=24 hours) 72











0 1 2 3 >3


0

20

40

60

80

100

16.3%

24.1% 23.2%18.4% 18.1%


No 54 16.3Yes 278 83.7






A 38 11.4ABEG 38 11.4

AB 19 5.7BEG 18 5.4

AG 17 5.1ABG 16 4.8

B 16 4.8BG 13 3.9

E 12 3.6G 12 3.6

Missing 0




Missing 0






Missing 0






None 206 62.0Mild 60 18.1



None 172 51.8pH <= 7.3, PaCO2 < 45 mmHg 49 14.8


PROSAFE project





Atelectasis 8 2.4Upper respiratory tract disease 6 1.8

Pneumothorax/Pneumomediastinum 6 1.8Aspiration pneumonia 6 1.8

Cardiovascular 55 16.6Left heart failure without pulm. edema 13 3.9

Left heart failure with pulmonary edema 10 3.0Acute severe arrhythmia: tachycardias 10 3.0

Systemic hypertensive crisis 4 1.2Acute myocardial infarction 4 1.2


Cerebral Aneurysm 7 2.1Spontaneous Subarachnoid haemorrhage 7 2.1

Metabolic/postanoxic encephalopathy 6 1.8Intracranial hypertension 5 1.5

Gastrointestinal and hepatic 99 29.8Gastrointestinal perforation 26 7.8

Gastrointestinal bleeding: upper tract 14 4.2Intestinal occlusion 14 4.2

Anastomotic dehiscence 12 3.6Digestive tract malignancy 12 3.6

Trauma (anatomical districts) 105 31.6Head 65 19.6Chest 41 12.3



- 0 0.0Other 75 22.6

Metabolic disorder 53 16.0Coagulation disorder 9 2.7

Nephrourologic disease 8 2.4Obstetric disease 4 1.2

Obstetric Haemorrhage 3 0.9Post transplantation 0 0.0

- 0 0.0- 0 0.0

Infections 169 50.9NON-surgical secondary peritonitis 40 12.0

Pneumonia 36 10.8Primary peritonitis 22 6.6

Post-surgical peritonitis 20 6.0Cholecystitis/cholangitis 14 4.2

NON-surgical skin/soft tissue infection 10 3.0NON-surgical urinary tract infection 9 2.7

L.R.T.I. other than pneumonia 7 2.1Tertiary peritonitis 7 2.1

Clinical sepsis 5 1.5Missing 0


Head 65 19.6Traumatic Subdural haemathoma 37 11.1

Skull fracture 34 10.2Cerebral contusion/laceration 28 8.4

Traumatic subarachnoid haemorrhage 26 7.8Extradural/epidural haematoma 13 3.9



Traum. haemothorax/pneumothorax 32 9.6Other injuries of the chest 18 5.4

Severe lung contusion/laceration 17 5.1Abdomen 17 5.1


Liver: Moderate-Severe laceration 4 1.2Pelvis/bone/joint & muscle 34 10.2



Neck vessels: dissection/transection 1 0.3Major thoracic vessels: transection 1 0.3

Aorta: rupture/dissection 1 0.3Miscellaneous 0 0.0

- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

35.5%

25.4%

39.1%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

10

20

30

40






0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

SAPSIIMean 42.8

SD 17.5Median 42Q1-Q3 29-53


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

5

10

15

20

SOFAMean 5.9



PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTImodel


No 162 48.8Yes 170 51.2

Missing 0


No 267 80.4Yes 65 19.6






B 14 4.2E 11 3.3A 5 1.5

AB 3 0.9ABE 3 0.9BCE 3 0.9

C 3 0.9ABCE 2 0.6BCEH 2 0.6

D 2 0.6Missing 0




Missing 0









Missing 0


None 302 91.0Mild 4 1.2




Atelectasis 7 2.1Pneumothorax/Pneumomediastinum 5 1.5

Aspiration pneumonia 3 0.9Upper resp. tract disease 2 0.6


Cardiac arrest 17 5.1Acute severe arrhythmia: bradycardias 7 2.1

Left heart failure w/o pulm. edema 6 1.8Hypertensive crisis 5 1.5


Brain edema 7 2.1Intracranial hypertension 6 1.8

New ischaemic stroke 5 1.5Post-surgical intracranial bleeding 3 0.9Gastrointestinal and hepatic 32 9.6

Paralytic Ileous 10 3.0Anastomotic dehiscence 6 1.8

Liver Dysfunction Syndrome 6 1.8Bowel ischaemia 3 0.9

Gastrointestinal perforation 3 0.9Other 20 6.0


Other disease 4 1.2Other skin and/or soft tissue pathology 3 0.9

- 0 0.0- 0 0.0- 0 0.0


L.R.T.I. other than pneumonia 8 2.4Gastroenteritis 4 1.2Clinical sepsis 3 0.9

NON-surgical secondary peritonitis 3 0.9NON-surgical urinary tract infection 3 0.9

Catheter-related bacteremia (CR-BSI) 2 0.6Other fungal infections 2 0.6

Post-surgical peritonitis 2 0.6Pleurisy/Pleural empyema 2 0.6

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTImodel

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 131 (80.4%) 28 (17.2%) 3 (1.8%) 1 (0.6%) 163


SEVERE SEPSIS - - 35 (81.4%) 8 (18.6%) 43

SEPTIC SHOCK - - - 66 (100.0%) 66

TOT 131 84 41 76 332


No 311 93.7Yes 21 6.3

Missing 0


Estimate 13.7CI (95%) 6.7-23.2


Estimate 11.0%CI (95%) 5.4-18.6


No 330 99.4Yes 2 0.6

Missing 0


Estimate 0.8CI (95%) 0.0-3.1


Estimate 1.0%CI (95%) 0.0-3.8

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)32

698

.2In

vasi

veve

ntila

tion

283

85.2

212

63.9

5416

.34

2-8

00

0-0

0N

onin

vasi

veve

ntila

tion

5015

.14

1.2

267.

81

0-2

02

1-4

0Tr

ache

osto

my

5917

.82

0.6

4313

74-

130

96-

100

iNO

(inha

led

nitr

icox

ide)

00.

0C

entra

lVen

ous

Cat

hete

r27

482

.582

24.7

181

54.5

63-

110

00-

00

Art

eria

lCat

hete

r27

181

.610

631

.989

26.8

53-

100

00-

00

Vaso

activ

edr

ugs

162

48.8

6419

.336

10.8

21-

40

00-

10

Ant

iarr

hyth

mic

s47

14.2

61.

826

7.8

32-

50

10-

20

IAB

P0

0.0

Inva

sive

mon

itorin

gof

C.O

.27

8.1

30.

93

0.9

62-

90

00-

10

Con

tinou

sm

onito

ring

ofS

cVO

26

1.8

20.

61

0.3

53-

120

00-

00

Tem

pora

rypa

cing

20.

61

0.3

10.

34

3-6

00

0-0

0Ve

ntric

ular

assi

stan

ce1

0.3

10.

30

03

3-3

0D

C-s

hock

41.

22

1-12

0C

PR

206.

04

1-8

0M

assi

vebl

ood

trans

fusi

on28

8.4

00-

00

Intra

cran

ialp

ress

ure

30.

92

0.6

00

76-

80

00-

00

Intra

vent

ricul

arde

vice

3610

.827

8.1

92.

77

4-9

00

0-0

0H

aem

ofiltr

atio

n1

0.3

00

10.

35

5-5

018

18-1

80

Hae

mod

ialy

sis

206.

03

0.9

72.

16

2-8

01

1-3

0E

CM

O0

0.0

Hep

atic

clea

ranc

ete

chni

ques

00.

0C

lear

ance

tech

niqu

esdu

ring

seps

is0

0.0

IAP

(intra

-abd

omin

alpr

essu

re)

10.

3H

ypot

herm

ia2

0.6

Ent

eral

nutr

ition

238

71.7

257.

519

859

.66

2-11

01

0-2

0P

aren

tera

lnut

ritio

n12

838

.614

4.2

5316

42-

60

10-

10

SD

D(T

opic

al,T

opic

alan

dsy

stem

ic)

00.

0P

atie

ntre

stra

int

10.

3Va

cuum

ther

apy

00.

0A

ntib

iotic

s29

588

.9A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

138

41.6

104

31.3

8124

.45

2-8

00

0-0

0A

ntib

iotic

sfo

rmed

ical

prop

hyla

xis

123.

65

1.5

51.

52

2-3

01

0-2

0E

mpi

rical

antib

iotic

ther

apy

168

50.6

7622

.990

27.1

43-

60

00-

10

Targ

eted

antib

iotic

ther

apy

7322

.011

3.3

5817

.57

4-12

04

3-7

0

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltem

erge

ncy

surg

ical

patie

nts

with

LOS

>=24

hour

sev

alua

ted

inth

eG

iViT

Imod

el

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTI model


Due to pulmonary failure 114 40.3 6.7 7.3 4 2-7.8 0For airway mainteinance 116 41.0 5.9 5.3 4 2-9 0


Reintubation within 48 hours 9 3.2 5.0 5.7 2 1-5 0




Missing 0





Missing 0


Mean 8.2SD 3.4

Median 9Q1-Q3 6-10




Missing 0

SDD (N=0) N %


Missing 0




Missing 2


No 291 87.7Yes 41 12.3

Missing 0


0 291 87.71 35 10.52 5 1.53 1 0.3

>3 0 0.0Missing 0


Mean 6.2SD 3.6

Median 6Q1-Q3 3-8.2

Missing 0



Orthopaedic surgery 5 1.5Other surgery 5 1.5

Nephro/Urological surgery 4 1.2ENT surgery 2 0.6

Pancreatic surgery 1 0.3Hepatic surgery 1 0.3

Gynaecological surgery 1 0.3Maxillo-Facial surgery 1 0.3

Missing 0


No 326 98.2Yes 6 1.8

Missing 0


Mean 14.3SD 8.9

Median 15Q1-Q3 9-19

Missing 0




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 235 70.8Dead 97 29.2

Missing 0




Missing 0


Alive 183 55.1Dead 149 44.9

Missing 0





Mean 20.1SD 28.9

Median 9.5Q1-Q3 3-23.5

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult emergency surgical patients with LOS>=24 hours evaluated in the GiViTI model


Alive 183 55.1Dead 149 44.9

Missing 0



Missing 0


Mean 8.4SD 9.3


Missing 0


Mean 7.2SD 7.2

Median 5Q1-Q3 2-10

Missing 0


Mean 17.8SD 24.8

Median 10Q1-Q3 4-21

Missing 0


SD 29.6Median 16Q1-Q3 9-31.2

Missing 0


Mean 29.8SD 30.2

Median 18Q1-Q3 12-37.5

Missing 0


Mean 21.0SD 28.2

Median 13Q1-Q3 6-23

Missing 0

PROSAFE project


PROSAFE project

82

National report for general ICUs - Year 2011Characteristics on admission - Adult patients with LOS<24 hours evaluated in the GiViTI model

Patients (N): 175

Sex N %


Age (years) N %

17-45 22 12.646-65 72 41.166-75 33 18.9>75 48 27.4

Missing 0Mean 63.6

SD 14.9Median 64Q1-Q3 55-76.5

Min-Max 19-91




Missing 0




Missing 0

Comorbidities N %

No 26 14.9Yes 149 85.1

Missing 0



Diabetes Type II without insulin tr. 31 17.7NYHA class II-III 30 17.1

Arrhythmia 27 15.4Cerebrovascular disease 27 15.4

NYHA class IV 21 12.0Moderate COPD 21 12.0

Myocardial infarction 21 12.0Any tumour without metastasis 18 10.3

Missing 0



Missing 0



Missing 0








Missing 0










No 155 88.6Yes 20 11.4

Missing 0

PROSAFE project

83 Adult patients (LOS<24 hours)


Trauma N %

No 157 89.7Yes 18 10.3


Surgical status N %



60.0%18.9%

21.1%

Surgical status





Missing 0


Gastrointestinal surgery 7 21.2Nephro/Urological surgery 5 15.2


Other surgery 4 12.1Hepatic surgery 2 6.1

Peripheral vascular surgery 2 6.1Neurosurgery 2 6.1


Missing 0




Missing 0


Gastrointestinal surgery 22 59.5Orthopaedic surgery 4 10.8


Thoracic surgery 2 5.4Abdominal vascular surgery 2 5.4


Hepatic surgery 1 2.7Thoracic vascular surgery 1 2.7

Missing 0




Missing 0







Missing 1


Interventional radiology 2 50.0Interventional endoscopy 2 50.0Interventional cardiology 0 0.0


PROSAFE project

Adult patients (LOS<24 hours) 84











0 1 2 3 >3


0

20

40

60

80

100

25.1%

16.6% 14.3%

22.9% 21.1%


No 44 25.1Yes 131 74.9






ABEG 19 10.9BEG 16 9.1

A 10 5.7ABG 10 5.7

B 6 3.4BG 6 3.4

G 6 3.4ABCEG 5 2.9

AE 5 2.9AB 4 2.3

Missing 0




Missing 0






Missing 0






None 100 57.1Mild 33 18.9



None 89 50.9pH <= 7.3, PaCO2 < 45 mmHg 24 13.7


PROSAFE project




Respiratory 30 17.1Acute exacerbation of COPD 7 4.0

Pulmonary embolism 5 2.9Pleural effusion 4 2.3

Lung cancer 4 2.3Aspiration pneumonia 4 2.3


Left heart failure with pulmonary edema 15 8.6Acute myocardial infarction 15 8.6

Left heart failure without pulm. edema 14 8.0Right heart failure 11 6.3


Spontaneous Subarachnoid haemorrhage 5 2.9Spontaneous Intraparenchymal bleeding 4 2.3

Vertebral basilar ischemic stroke 3 1.7Metabolic/postanoxic encephalopathy 3 1.7

Gastrointestinal and hepatic 40 22.9Gastrointestinal bleeding: upper tract 6 3.4

Liver Dysfunction Syndrome 5 2.9Intestinal occlusion 4 2.3

Paralytic Ileus 4 2.3Bowel ischaemia 4 2.3

Trauma (anatomical districts) 18 10.3Head 11 6.3

Pelvis/bone/joint & muscle 9 5.1Chest 6 3.4Spine 4 2.3


- 0 0.0Other 61 34.9


Coagulation disorder 7 4.0Other disease 7 4.0


- 0 0.0- 0 0.0


NON-surgical urinary tract infection 7 4.0NON-surgical secondary peritonitis 6 3.4

L.R.T.I. other than pneumonia 4 2.3Clinical sepsis 3 1.7

Primary peritonitis 3 1.7NON-surgical skin/soft tissue infection 3 1.7

Gastroenteritis 2 1.1Tertiary peritonitis 2 1.1

NON-surgical bone and joint infection 1 0.6Missing 0


Head 11 6.3Cerebral contusion/laceration 5 2.9

Traumatic Subdural haemathoma 4 2.3Traumatic Intraparenchimal bleeding 4 2.3

Maxillofacial fracture 4 2.3Skull fracture 3 1.7

Spine 4 2.3Vertebral fracture, without deficit 2 1.1

Tetraplegia 1 0.6Lumbar injury, incomplete deficit 1 0.6

Chest 6 3.4Other injuries of the chest 4 2.3

Traum. haemothorax/pneumothorax 2 1.1Severe lung contusion/laceration 2 1.1

Abdomen 3 1.7Liver: Massive laceration 2 1.1

Bowel transection/perforation 1 0.6- 0 0.0



Major vessels injury 2 1.1Major thoracic vessels: transection 1 0.6

Aorta: rupture/dissection 1 0.6Cava: rupture/transection 1 0.6

Miscellaneous 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

41.5%

11.3%

47.2%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult patients with LOS<24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

10

20

30

40

50

60 On admissionWorst value in the first 24 hours GCS (admission)



GCS (first 24 hours)Median 15Q1-Q3 10.2-15


0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

5

10

15

20

SAPSIIMean 36.9

SD 25.2Median 30.5Q1-Q3 19-45.8


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

10

20

30

40

SOFAMean 4.2



PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult patients with LOS<24 hours evaluated in the GiViTI model


No 97 55.4Yes 78 44.6

Missing 0


No 149 85.1Yes 26 14.9






B 8 4.6G 3 1.7A 2 1.1

BC 2 1.1H 2 1.1

ABC 1 0.6ABCE 1 0.6

BCE 1 0.6BCEH 1 0.6

BCH 1 0.6Missing 0




Missing 0









Missing 0


None 169 96.6Mild 1 0.6



Respiratory 3 1.7ARDS 1 0.6

Pleural effusion 1 0.6Pneumothorax/Pneumomediastinum 1 0.6

- 0 0.0- 0 0.0


Acute severe arrhythmia: bradycardias 7 4.0Acute severe arrhythmia: tachycardias 5 2.9

Acute ischaemia 2 1.1Pulmonary edema 2 1.1

Neurological 5 2.9Brain edema 2 1.1

Drowsiness/agitation/delirium 2 1.1Intracranial hypertension 1 0.6

New ischaemic stroke 1 0.6Seizures 1 0.6

Gastrointestinal and hepatic 2 1.1Bowel ischaemia 2 1.1

- 0 0.0- 0 0.0- 0 0.0- 0 0.0


Nephrourologic disease 2 1.1- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Infections 1 0.6Clinical sepsis 1 0.6

- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult patients with LOS<24 hours evaluated in the GiViTI model

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 122 (100.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 122


SEVERE SEPSIS - - 5 (83.3%) 1 (16.7%) 6

SEPTIC SHOCK - - - 25 (100.0%) 25

TOT 122 21 6 26 175

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)16

694

.9In

vasi

veve

ntila

tion

124

70.9

8146

.346

26.3

Non

inva

sive

vent

ilatio

n11

6.3

42.

37

4Tr

ache

osto

my

00.

0iN

O(in

hale

dni

tric

oxid

e)0

0.0

Cen

tralV

enou

sC

athe

ter

7542

.934

19.4

4626

.3A

rter

ialC

athe

ter

8950

.946

26.3

5028

.6Va

soac

tive

drug

s83

47.4

4626

.334

19.4

Ant

iarr

hyth

mic

s30

17.1

74

95.

1IA

BP

00.

0In

vasi

vem

onito

ring

ofC

.O.

10.

60

00

0C

ontin

ous

mon

itorin

gof

ScV

O2

21.

10

00

0Te

mpo

rary

paci

ng3

1.7

10.

63

1.7

Vent

ricul

aras

sist

ance

00.

0D

C-s

hock

126.

9C

PR

4324

.6M

assi

vebl

ood

trans

fusi

on7

4.0

Intra

cran

ialp

ress

ure

10.

61

0.6

10.

6In

trave

ntric

ular

devi

ce3

1.7

10.

61

0.6

Hae

mofi

ltrat

ion

10.

60

00

0H

aem

odia

lysi

s1

0.6

10.

61

0.6

EC

MO

00.

0H

epat

iccl

eara

nce

tech

niqu

es0

0.0

Cle

aran

cete

chni

ques

durin

gse

psis

00.

0IA

P(in

tra-a

bdom

inal

pres

sure

)0

0.0

Hyp

othe

rmia

31.

7E

nter

alnu

triti

on35

20.0

158.

631

17.7

Par

ente

raln

utrit

ion

52.

91

0.6

42.

3S

DD

(Top

ical

,Top

ical

and

syst

emic

)0

0.0

Pat

ient

rest

rain

t2

1.1

Vacu

umth

erap

y0

0.0

Ant

ibio

tics

6738

.3A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

2514

.319

10.9

126.

9A

ntib

iotic

sfo

rmed

ical

prop

hyla

xis

10.

61

0.6

10.

6E

mpi

rical

antib

iotic

ther

apy

4123

.423

13.1

2313

.1Ta

rget

edan

tibio

ticth

erap

y1

0.6

00

00

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltpa

tient

sw

ithLO

S<2

4ho

urs

eval

uate

din

the

GiV

iTIm

odel

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult patients with LOS<24 hours evaluated in the GiViTI model

Invasive ventilation (N=124) N %Due to pulmonary failure 62 50.0For airway mainteinance 42 33.9

In weaning 10 8.1Not evaluable 10 8.1

Reintubation within 48 hours 0 0.0




Missing 0





Missing 0




Missing 0

SDD (N=0) N %


Missing 0




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult patients with LOS<24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 78 44.6Dead 97 55.4

Missing 0




Missing 0


Alive 67 38.3Dead 108 61.7

Missing 0





Mean 12.5SD 19.0

Median 3Q1-Q3 2-13

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult patients with LOS<24 hours evaluated in the GiViTI model


Alive 66 37.7Dead 109 62.3

Missing 0


Mean 8.5SD 12.8

Median 3.5Q1-Q3 0-11.5

Missing 0



Missing 0


Mean 9.9SD 11.9

Median 6Q1-Q3 1-14

Missing 0


Mean 9.7SD 29.0

Median 1.5Q1-Q3 1-8

Missing 0

PROSAFE project


PROSAFE project

94

National report for general ICUs - Year 2011Characteristics on admission - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model

Patients (N): 33

Sex N %


Age (years) N %

17-45 3 9.146-65 17 51.566-75 4 12.1>75 9 27.3

Missing 0Mean 64.1

SD 13.1Median 61Q1-Q3 55-76

Min-Max 42-88




Missing 0




Missing 0

Comorbidities N %

No 3 9.1Yes 30 90.9

Missing 0


Hypertension 23 69.7Any tumour without metastasis 10 30.3

Moderate COPD 7 21.2Cerebrovascular disease 6 18.2

Peripheral vascular disease 6 18.2Diabetes Type II without insulin tr. 5 15.2

NYHA class II-III 4 12.1Myocardial infarction 3 9.1Peptic ulcer disease 3 9.1

Arrhythmia 2 6.1Missing 0



Missing 0



Missing 0








Missing 0










No 14 42.4Yes 19 57.6

Missing 0

PROSAFE project

95 Elective surgical (LOS<24 hours)


Trauma N %

No 31 93.9Yes 2 6.1


Surgical status N %



0.0%

100.0%

0.0%

Surgical status





Missing 0


Gastrointestinal surgery 7 21.2Nephro/Urological surgery 5 15.2


Other surgery 4 12.1Hepatic surgery 2 6.1



Missing 0




Missing 0


- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0







Missing 1




Missing 0

PROSAFE project

Elective surgical (LOS<24 hours) 96











0 1 2 3 >3


0

20

40

60

80

100

51.5%

18.2% 18.2%

6.1% 6.1%


No 17 51.5Yes 16 48.5






BG 4 12.1A 3 9.1G 2 6.1

ABG 1 3.0AE 1 3.0

BCEG 1 3.0BDEGH 1 3.0

BGH 1 3.0D 1 3.0

EG 1 3.0Missing 0




Missing 0






Missing 0






None 29 87.9Mild 2 6.1



None 22 66.7pH <= 7.3, PaCO2 < 45 mmHg 4 12.1


PROSAFE project




Respiratory 5 15.2Lung cancer 3 9.1

Upper respiratory tract disease 2 6.1Haemothorax (non traumatic) 1 3.0

- 0 0.0- 0 0.0

Cardiovascular 7 21.2Left heart failure without pulm. edema 4 12.1

Cardiac arrest 3 9.1Left heart failure with pulmonary edema 1 3.0

Acute severe arrhythmia: tachycardias 1 3.0Acute ischaemia 1 3.0Neurological 2 6.1

Cerebral artery stroke 1 3.0Polyneuropathy/myopathy 1 3.0

- 0 0.0- 0 0.0- 0 0.0


Liver Dysfunction Syndrome 2 6.1Hepatic malignancy 2 6.1

Anastomotic dehiscence 1 3.0- 0 0.0

Trauma (anatomical districts) 2 6.1Pelvis/bone/joint & muscle 2 6.1

- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0


Other disease 5 15.2Nephrourologic disease 4 12.1

Coagulation disorder 2 6.1Orthopaedic disease 2 6.1

Post transplantation 0 0.0- 0 0.0- 0 0.0

Infections 3 9.1NON-surgical bone and joint infection 1 3.0

Pleurisy/Pleural empyema 1 3.0Tertiary peritonitis 1 3.0

- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0


Head 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Spine 0 0.0- 0 0.0- 0 0.0- 0 0.0

Chest 0 0.0- 0 0.0- 0 0.0- 0 0.0

Abdomen 0 0.0- 0 0.0- 0 0.0- 0 0.0



Major vessels injury 0 0.0- 0 0.0- 0 0.0- 0 0.0

Miscellaneous 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0

100.0%

0.0%0.0%




PROSAFE project


National report for general ICUs - Year 2011Severity scores - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model

3 4 5 6 7 8 9 10 11 12 13 14 15


0

20

40

60

80

100

On admissionWorst value in the first 24 hours GCS (admission)





0−4

5−9

10−

14

15−

19

20−

24

25−

29

30−

34

35−

39

40−

44

45−

49

50−

54

55−

59

60−

64

65−

69

70−

74

75−

79

80−

84

85−

89

90−

94

95−

99

100−

104

105−

109

110−

114

115−

119

>=

120

SAPS II (%)

0

10

20

30SAPSII

Mean 18.2SD 10.0

Median 18Q1-Q3 10.5-23.5


0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24

SOFA (%)

0

10

20

30

40

50

60

70

SOFAMean 1.4

SD 1.5Median 1Q1-Q3 0.5-1.5


PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model


No 27 81.8Yes 6 18.2

Missing 0


No 32 97.0Yes 1 3.0






B 1 3.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0




Missing 0









Missing 0


None 33 100.0Mild 0 0.0



Respiratory 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0


Acute ischaemia 1 3.0Acute severe arrhythmia: bradycardias 1 3.0

- 0 0.0- 0 0.0

Neurological 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Gastrointestinal and hepatic 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Other 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Infections 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0- 0 0.0

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Characteristics during the stay - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model

Infections N %



Missing 0




Missing 0




SEPTICSHOCK

TOT

Adm

issi

on

None 30 (100.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 30


SEVERE SEPSIS - - 0 (0.0%) 0 (0.0%) 0

SEPTIC SHOCK - - - 0 (0.0%) 0

TOT 30 3 0 0 33

PROSAFE project


Use

On

adm

issi

onO

ndi

scha

rge

Leng

th(d

ays)

Day

sfro

mad

mis

sion

Pro

cedu

res

and/

ortre

atm

ents

(Mis

sing

=0)

N%

N%

N%

Med

ian

Q1-

Q3

Mis

sing

Med

ian

Q1-

Q3

Mis

sing

Pro

cedu

res

(ant

ibio

tics

excl

uded

)29

87.9

Inva

sive

vent

ilatio

n17

51.5

1339

.42

6.1

Non

inva

sive

vent

ilatio

n4

12.1

26.

13

9.1

Trac

heos

tom

y0

0.0

iNO

(inha

led

nitr

icox

ide)

00.

0C

entra

lVen

ous

Cat

hete

r7

21.2

26.

11

3A

rter

ialC

athe

ter

1957

.612

36.4

618

.2Va

soac

tive

drug

s7

21.2

39.

11

3A

ntia

rrhy

thm

ics

39.

10

01

3IA

BP

00.

0In

vasi

vem

onito

ring

ofC

.O.

00.

0C

ontin

ous

mon

itorin

gof

ScV

O2

00.

0Te

mpo

rary

paci

ng1

3.0

13

13

Vent

ricul

aras

sist

ance

00.

0D

C-s

hock

00.

0C

PR

13.

0M

assi

vebl

ood

trans

fusi

on1

3.0

Intra

cran

ialp

ress

ure

00.

0In

trave

ntric

ular

devi

ce0

0.0

Hae

mofi

ltrat

ion

00.

0H

aem

odia

lysi

s0

0.0

EC

MO

00.

0H

epat

iccl

eara

nce

tech

niqu

es0

0.0

Cle

aran

cete

chni

ques

durin

gse

psis

00.

0IA

P(in

tra-a

bdom

inal

pres

sure

)0

0.0

Hyp

othe

rmia

13.

0E

nter

alnu

triti

on8

24.2

39.

18

24.2

Par

ente

raln

utrit

ion

13.

00

01

3S

DD

(Top

ical

,Top

ical

and

syst

emic

)0

0.0

Pat

ient

rest

rain

t1

3.0

Vacu

umth

erap

y0

0.0

Ant

ibio

tics

1236

.4A

ntib

iotic

sfo

rsur

gica

lpro

phyl

axis

1030

.39

27.3

39.

1A

ntib

iotic

sfo

rmed

ical

prop

hyla

xis

00.

0E

mpi

rical

antib

iotic

ther

apy

26.

11

31

3Ta

rget

edan

tibio

ticth

erap

y0

0.0

Nat

iona

lrep

ortf

orge

nera

lIC

Us

-Yea

r20

11P

roce

ssin

dica

tors

-Adu

ltel

ectiv

esu

rgic

alpa

tient

sw

ithLO

S<2

4ho

urs

eval

uate

din

the

GiV

iTIm

odel

PROSAFE project


National report for general ICUs - Year 2011Process indicators - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model

Invasive ventilation (N=17) N %Due to pulmonary failure 4 23.5For airway mainteinance 5 29.4

In weaning 6 35.3Not evaluable 2 11.8

Reintubation within 48 hours 0 0.0




Missing 0





Missing 0




Missing 0

SDD (N=0) N %


Missing 0




Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model

ICU outcome N %



Missing 0








Missing 0









ICU mortality N %

Alive 27 81.8Dead 6 18.2

Missing 0




Missing 0


Alive 22 66.7Dead 11 33.3

Missing 0





Mean 23.2SD 24.5

Median 12Q1-Q3 9-30

Missing 0

PROSAFE project


National report for general ICUs - Year 2011Outcome indicators - Adult elective surgical patients with LOS<24 hours evaluated in the GiViTI model


Alive 22 66.7Dead 11 33.3

Missing 0


Mean 10.3SD 13.9

Median 6Q1-Q3 2.5-12

Missing 0


SD 17.5Median 10Q1-Q3 5-17

Missing 0


Mean 11.6SD 9.1

Median 10Q1-Q3 5-14.8

Missing 0


Mean 22.5SD 26.9

Median 10Q1-Q3 6-25

Missing 0

PROSAFE project


PROSAFE project

106

PROSAFE project

Appendix

107

PROSAFE project

108

Coauthors

PROSAFE project

CSOMÓS ÁKOS (BUDAPEST), SZEDLÁK BALÁZS (MISKOLC), GÁBOR CSATÓ (DEBRECEN), HUBAY ZSOLT(SOPRON), KOVÁCS MIHÁLY (MISKOLC), VOLGYES BARBARA (BUDAPEST) .

109 Coauthors

report prosafe project - europa · 2013-01-07 · prosafe project prosafe project-national report...

Documents