A study on APACHE II severity scoring system in Intensive Care Unit Hospital University Sains Malaysia

Sistem penilaian keterukan pesakit telah digunakan secara meluas untuk mengkaji keadaan pesakit yang dimasukkan ke unit rawatan rapi samada untuk melihat perubahan fisiologi atau keberkesanan rawatan dan menilik kadar kematian. APACHE ll merupakan system penilaian yang selalu digunakan kerana ia adalah senang dikendalikan dan mudah diperolehi. Selama 12 bulan, dari Januari 2000 ke Disember 2000, seramai 180 pesakit telah dimasukkan ke unit rawatan rapi, hospital Universiti Sains Malaysia. Kemasukkan adalah berdasarkan criteria yang telah ditetapkan di dalam kajian ini. Severity scoring system have been widely used for assessment of patients admitted to intensive care unit whether to see the physiological derangement or the effectiveness of the treatment and prediction of mortality rate. APACHE II is the most commonly used severity scoring system because it is user friendly and easily available. For the past 12 months between January 2000 to December 2000, a total of 180 patients were admitted to the intensive care unit, Hospital University Sains Malaysia. Admission was based upon the criteria that have been tailored towards the study

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically