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TISS and mortality after discharge from intensive care

L Smith¹, C M Orts, I O'Neil

¹Department of Anaesthesia and Intensive Care, Royal Victoria Infirmary and the University Department of Surgical and Reproductive Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 4LP, UK.

Intensive Care Medicine

|November 7, 1999

Abstract

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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