Valeur ajoutée d'un système d'information clinique aux soins intensifs

Abstract

Depuis 30 ans au moins, les équipes médico-infirmières rêvent de systèmes informatiques pouvant intégrer la masse des données produites par et pour les patients. Il s'agit de trier, d'organiser et de resituer des informations de nature très variée d'une manière structurée et utilisable . L'informatisation des unités de soins intensifs (SI) du CHUV est un projet institutionnel "Hospices-CHUV", portant l'acronyme "SICASI", pour "système d'information clinique aux soins intensifs". Le projet concerne 41 lits de SI situés au niveau 05 du bâtiment hospitalier principal : ces lits sont répartis en trois unités, chirurgicale (17 lits), médicale (14 lits), et pédiatrique (10 lits). Le budget global dévolu à l'informatisation est de 2,5 millions de francs. Le projet a d'emblée été multidisciplinaire, englobant des médecins et des infirmiers des 3 unités, ainsi que des informaticiens. Il devrait aboutir à un changement fondamental de la manière de travailler en SI. [Extrait de l'introduction, p. 2]]]> Intensive Care Units ; Hospital Information Systems ; Medical Records Systems, Computerized ; Hospitals, University fre https://serval.unil.ch/resource/serval:BIB_C9A8235D6023.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_C9A8235D60232 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_C9A8235D60232 info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_C9A972CD5FE4 2022-05-07T01:26:59Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_C9A972CD5FE4 Postoperative 3D conformal radiation therapy with dose-volume histogram assessment in non small-cell lung cancer info:doi:10.1016/j.ijrobp.2007.07.1713 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijrobp.2007.07.1713 Zouhair, A. Drausanu, D. Matzinger, O. Pehlivan, B. Khanfir, K. Ris, H.B. Stupp, R. Moeckli, R. Mirimanoff, R.O. Ozsahin, M. info:eu-repo/semantics/conferenceObject inproceedings 2007 49th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, vol. 69, pp. S498-S499 info:eu-repo/semantics/altIdentifier/isbn/0360-3016 <![CDATA[Purpose/Objective(s): Despite many randomized trials, the indication of postoperative radiation therapy (PORT) in non small cell lung cancer (NSCLC) is controversial. Involved-field conformal (3D) RT has never been studied prospectively. In this study, we aim to assess the outcome of patients treated with involved-field 3D PORT with or without chemotherapy in locally advanced NSCLC. Materials/Methods: From 1990 to 2006, data from 75 consecutive patients treated with curative surgery and PORT for NSCLC were retrospectively analyzed. Male to female ratio was 57/18, and median age was 58 years (38-76). There were 5 patients with stage I, 22 with stage II, and 48 with stage III disease. Pneumonectomy or lobectomy was realized in 24 and 51 patients, respectively. Mediastinal lymphadenectomy was performed in all patients. PORT indications were positive margins and/or positive mediastinal lymph nodes. Cisplatin-based chemotherapy was given in 15 patients. All patients had 3D conformal planning. Median RT dose was 60 Gy using at least 6-MV photons in 6 weeks, and CTV included bronchial stump and only positive nodal areas. Dose-volume histograms (DVH) assessing the pulmonary volume receiving 20 Gy (V20 Gy) were used in all patients. Results: Compliance to PORT was 100%. In a median follow-up period of 55 months, 26 (35%) patients are alive without disease. Median overall survival time was 24 months, with survival rate of 35% at 5 years (Fig. 1). The 5-year locoregional control and distant disease-free rates were 80% and 57%, respectively. Patients treated with pneumonectomy and those treated with at least 60-Gy PORT had better outcome (Fig. 2). Grade 3 or more CTC v3.0 toxicity was observed only in 4 (5%) pts. No lethal toxicity was observed. Conclusions: We conclude that involved-field 3D conformal 60-Gy PORT tailored with DVH V20 Gy assessment improves locoregional control without increasing lethal toxicity. Prospective studies using the above-mentioned criteria are warranted