Summary:
ABSTRACT
Introduction: The decision, whether a patient should be admitted to ICU
provides an
ethical issue which requires a complex procedure to be followed. The doctor has
to
evaluate a group of factors including medical and organizational.
Scope: The assessment and evaluation of the factor that affects, the doctor to
decide
whether the [patients should be entered in ICU and the comparison between those
who haven’t. The descriptive essay took place on the hospital “EVAGELISMOS” and
lasted three months. The patients for whom an application to enter ICU was
deposited
were recorded. About those who didn’t achieve entering, the attending physician
answered a questionnaire for the reasons that played the major in his decision.
These
factors could be logistical infrastructure, clinical or social.
Results: During the essay a number of 9304 patients made a request for IC. In
the
study, 264 patients were included. 98 (37%) of them were hospitalized in ICU, 25
(9,4%) in intermediate care unit, while 141 (53,2) didn’t go in/enter. The
median age
of patients was 65,64 (+/-) 17,19 years old. The most common diagnosis was
respiratory problems (34,4%) and illness/disease of the CNS (22,3%). 22% of the
patients who didn’t manage to enter showed improvement in their health. On the
contrary 55,3% of them passed away, while a percentage of 22,7% were transferred
to other medical centers. For those who didn’t enter, were answered 137 (97%)
questionnaires. The determinative factor that affected doctor’s decision was in
what
level would the hospitalization improve the patients’ health (in the 25,5% of
the
cases). The severity of acute illness (22,6%) and lastly the lack of space
(21,2%).
Conclusion: The shortcoming of admitted patients in ICU is a common phenomenon
in Greece. The doctors in the attempt to decide who should enter in ICU take
mostly
into account the severity of acute illness and the lack of space in the medical
centers.
Keywords:
Criteria, Triage, ICU, Admission, Factors
