Therapeutic Intervention Scoring System-28 as a tool of post ICU outcome prognosis and prevention.

AIM: To examine the effects of severity upon discharge from Intensive Care Unit (ICU) status, as assessed by the Therapeutic Intervention Scoring System-28 (TISS-28) on subsequent post ICU outcome.

METHODS: One-year retrospective observational study. Six bed general ICU in a general hospital with no High Dependency ICU unit (HDU) available. We used data from all patients admitted to the ICU. From all discharged patients, data on mean length of ICU stay, APACHE II upon admission and TISS-28 upon discharge were collected.

RESULTS: Eighty-six patients, mean age 63.2, were discharged to hospital wards between January 1999 and December 1999. Age is a significant factor to contribute to outcome prediction, (p=0.0478). TISS-28 is statistically significant related to survival status. Thirteen patients that did not survive had higher TISS-28 values (p=0.0032). Length of ICU stay has a borderline association (p=0.063) with survival.

CONCLUSION: Patients discharged from ICU have post ICU hospital length of stay and prognosis related to their age, time of hospitalization in ICU and their severity status upon discharge from the ICU. We believe that, based on the TISS-28 scoring system, high risk patients can be identified and either ideally transferred to a HDU or discharged from ICU when further improvement has been achieved. TIS-28 is a valuable tool in post ICU outcome prediction and subsequently, in hospital mortality reduction. At the same time, through TISS-28 use, each hospital can locally identify the quality of care provided outside the ICU, given the outcomes measured in groups of patients at various severity levels.