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ArtículoDerechos de autor
Acceso restringido
Fecha del embargo
2030-12-31
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- INI - Artigos de Periódicos [3504]
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PROFILING AND BENCHMARKING CENTRAL NERVOUS SYSTEM INFECTIONS IN AN INFECTIOUS DISEASES INTENSIVE CARE UNIT
Autor
Afiliación
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil / Universidade Federal Fluminense. Instituto Biomédico. Setor de Doenças Sexualmente Transmissíveis. Niterói, RJ, Brasil.
Rush University Medical Center. Department of Neurological Sciences. Chicago, IL, USA.
Copa Star Hospital. Surgical Intensive Care Unit. Rio de Janeiro, RJ, Brazil / National Cancer Institute. Intensive Care Unit II. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Teaching. Department of Critical Care. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa em Imunização e Vigilância Sanitária. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Rush University Medical Center. Department of Neurological Sciences. Chicago, IL, USA.
Copa Star Hospital. Surgical Intensive Care Unit. Rio de Janeiro, RJ, Brazil / National Cancer Institute. Intensive Care Unit II. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Division of High-Consequence Pathology and Pathogens. National Center for Emerging and Zoonotic Infectious Diseases. Centers for Disease Control and Prevention. Atlanta, GA, USA.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil / D'Or Institute for Research and Teaching. Department of Critical Care. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa em Imunização e Vigilância Sanitária. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Unidade de Tratamento Intensivo. Rio de Janeiro, RJ, Brasil.
Resumen en ingles
Background: There is little information comparing the performance of community acquired central nervous system infections (CNSI) treatment by intensive care units (ICUs) specialized in infectious diseases with treatment at other ICUs. Our objective was to reduce these gaps, creating bases for benchmarking and future case-mix classification. Methods: This is a retrospective observational cohort of 785 admissions with 82 cases of CNSI admitted to the ICU of an important Brazilian referral center for infectious diseases (INI) between January 2012 and January 2019. Comparisons were made to data retrospectively collected from the 303,500 intensive care admissions from the Brazilian state health care system included in the Epimed Monitor database. Clinical, epidemiologic, and performance indicators: the standardized mortality rate (SMR) and the standardized resource use rate per ICU surviving patient (SRU) were collected. Results: Case-mix infections profile and SMR/SRU data. SUS Mixed medical/surgical ICUs: SMR = 1.26, SRU = 1.59; SUS Neurological ICUs: SMR = 1.17, SRU = 2.23; INI ICU: SMR = 1.1, SRU = 1.1; INI ICU CNSI patients: SMR = 0.95, SRU = 1.01. Conclusions: Severe patients with CNSI can be efficiently and effectively treated in an ICU specialized in infectious diseases when compared to mixed medical/surgical and neurological ICUs from the public health system. At the same time, we provided profiling and a case-mix that can help and encourage benchmarking by other institutions and other countries.
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