[Clinical care in a recovery room. Triennial review]

To evaluate clinical practice in our intensive care unit over a period of 3 consecutive years (January 1991-December 1993).

Retrospective computer analysis of clinical data recorded for the 1157 patients admitted during the study period.

Seven hundred thirteen men and 443 women were admitted. Mean age was 58.8 years. Eighty-nine percent had undergone elective or emergency surgery, 7% were non surgical emergency admissions and 4% were transferred from other hospital wards. The mean stay was 3.8 days, though the mean stay for elective surgery patients was significantly shorter (p < 0.001). We assess the usefulness of the APACHE-II scale applied during the first 24 hours of admission, finding that mean scores were significantly lower (p < 0.001) for the 1089 survivors (10.2 +/- 4.7) than for the 68 patients who died (23.6 +/- 9.4). The score on the APACHE II scale was above 16 for 82% of those who died. Overall mortality for the unit was 5.9%, though the proportion was statistically higher (p < 0.001) in emergency patients. Complications developed in 299, though the number of complications was significantly lower (p < 0.001) for elective surgery patients. The patients who died required more use of invasive monitoring and mechanical ventilation (p < 0.001).

Our review shows that mortality, lengthy of stay in the unit and number of complications were all greater among emergency admissions. The patients who died had higher mean APACHE-II scores and required more care. Computerized data collection and later analysis is a useful way to assess clinical practice and facilitate future studies.