TISS and mortality after discharge from intensive care

L Smith, C M Orts, I O'Neil, A M Batchelor, A D Gascoigne, S V Baudouin
Intensive Care Medicine 1999, 25 (10): 1061-5

OBJECTIVE: To examine the effect of high levels of pre-intensive care unit (ICU) discharge care, as assessed by the Therapeutic Intervention Scoring System (TISS), on subsequent hospital mortality.

DESIGN: A 1-year prospective, observational study.

SETTING: The ICU and wards of a university teaching hospital with no high dependency facility (HDU).

PATIENTS: A total of 283 patients were discharged to hospital wards between July 1997 and June 1998. ++

RESULTS: 11 % of all ICU discharges subsequently died in hospital. Patients discharged with a TISS of 20 or greater had a 21.4 % mortality compared to 3.7 % for those with a TISS of less than 10. Increasing age, Acute Physiology Score (APS) on admission and male sex were also significantly associated with post-discharge death.

CONCLUSIONS: In a hospital without HDU facilities, patients who are receiving HDU levels of care on discharge from the ICU have a high in-hospital mortality.

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