Paper was to objective the treatment and outcome of very old individuals (over 85 years) at a medical ICU of a common hospital over an 18-month period (1997-01-01 to 1998-06-30). Benefits and outcome: 899 patients had been admitted for the ICU through the study period, 48 (5.3 ) older than 85 years. At admission the APACHE II-score ranked amongst 19 and 32. Indications had been mainly cardial (27), metabolic (eight), gastrointestinal (6), outdoors CPR (five) and acute respiratory failure (2). 11 patients had been mechanical ventilated (1? days, mean 2.7 days), 6 patients received a cardiac pacemaker, five underwent endoscopical interventions, 4 thrombolysis (AMI, 100 mg Alteplase `front loaded’), two individuals PTCA/IABP and a single female patient ACBG. Duration of stay had been 3.8 days (general three.9 days), mortality 27.7 (overall 14.8 ).Conclusion: Comorbidity and mortality had been greater in individuals older than 85 years in comparison to all individuals. six month just after the ICU keep 24 patients (68.5 ) were still alive. With great quality of life. Despite higher mortality quite old patients benefit from ICU remain and interventions.P264 High quality control with autopsy on a medical intensive care unitJ Roosen, E Frans, A Wilmer, S Vanderschueren and H Bobbaers Division of Medical Intensive Care, U.Z. Gasthuisberg, Leuven, Belgium Postmortem examination is viewed as because the golden regular for the evaluation of clinical diagnosis. However on account of numerous reasons (expenses, permission of loved ones members), few medicalCrit Care 1999, 3 (suppl 1):PPoster abstractscenters continue to perform autopsy as a means of good quality handle. From 1995 to 1996, we PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20719346 performed an autopsy study within a healthcare intensive care unit of a university hospital: 93 of your 140 deceased individuals in our health-related ICU underwent an autopsy, 100 consecutive patient files had been studied. The clinical diagnosis were made by internists, specialized in intensive medicine; the diagnosis on autopsy were produced by a pathologist. In accordance with the criteria of Goldman[1], the clinical and autopsy findings have been categorized into key and minor diagnoses. A Chrysophanic acid biological activity missed diagnosis on clinical grounds was classified as a class I error (if detected ahead of death, this would likely have triggered a therapeutic change with achievable altered outcome) or as a class II error (if recognized ahead of death, this diagnosis wouldn’t have led to a change in therapy). In 16 in the patients, a class I missed diagnosis was detected (cardiac tamponade, myocardial infarction, fungal pneumonia); in 9 , a class II missed diagnosis was detected (most often tumors). In some cases the diagnosis was missed on account of a mixture of severe, acute issues (e.g. development of cardiac tam-ponade soon after insertion of a venous catheter in the course of hemorraghic shock), or on account of a lack of sensitive and certain investigational approaches (fungal pneumonia is often suspected in immunocompromised patients, but is usually complicated to confirm), or as a result of logistic transportation problems within the hemodynamically unstable patient (e.g. retroperitoneal hemorrhage just isn’t constantly detectable on bedside echography; for diagnosis, CAT-scan is required). Conclusion: Even inside the era of growing diagnostic possibilities, due to enhanced health-related technologies within the ICU, postmortem examination nevertheless remains beneficial in detecting unexpected diagnoses, missed within the premortem clinical evaluation. Our observations recommended the have to have for continuous alertness and an aggressive investigational organizing in patien.
