BACKGROUND: Few data are available on intensive care unit (ICU) patient populations and critical care medicine practices in developing countries. METHODS: This prospective study evaluated differences in patient characteristics, ICU practice, and outcome between the ICUs of a Mongolian 400-bed tertiary university hospital (MonICU) and an Austrian 429-bed secondary hospital (AutICU). Demographics, chronic health status, clinical parameters, disease and therapeutic severity scores, and outcome were documented for all patients admitted to the two ICUs during a period of four and a half months. Standard tests and multiple regression analysis were used for statistical analysis. RESULTS: A total of 203 critically ill patients were admitted to MonICU and 257 to AutICU. MonICU patients had fewer chronic diseases than AutICU patients (0.9 +/- 0.8 vs. 2.7 +/- 1.5, P < 0.001) but more frequently suffered from tuberculosis (2.5% vs. 0%, P = 0.01) and more frequently had never been medically examined before ICU admission (10.8% vs. 0%, P < 0.001). Admission diagnoses differed both in type and relative proportions in the two ICUs (P < 0.001). Admission of MonICU patients was more frequently unplanned (69% vs. 50.2%, P < 0.001), and although disease was more severe in these patients they received fewer therapeutic interventions than the AutICU patients. Overall mortality was higher in the MonICU patients (19.7 vs. 6.2%, P < 0.001). CONCLUSIONS: Patient characteristics and ICU practices varied significantly between the two ICUs. Mortality was substantially greater at MonICU, particularly among patients suffering from multiple-organ dysfunction. Strategies to improve the care of critically ill patients at MonICU should address both system- and staff-related problems, improve acceptance of the ICU service among physicians of other disciplines and upgrade the training of ICU staff.
BACKGROUND: Few data are available on intensive care unit (ICU) patient populations and critical care medicine practices in developing countries. METHODS: This prospective study evaluated differences in patient characteristics, ICU practice, and outcome between the ICUs of a Mongolian 400-bed tertiary university hospital (MonICU) and an Austrian 429-bed secondary hospital (AutICU). Demographics, chronic health status, clinical parameters, disease and therapeutic severity scores, and outcome were documented for all patients admitted to the two ICUs during a period of four and a half months. Standard tests and multiple regression analysis were used for statistical analysis. RESULTS: A total of 203 critically illpatients were admitted to MonICU and 257 to AutICU. MonICU patients had fewer chronic diseases than AutICU patients (0.9 +/- 0.8 vs. 2.7 +/- 1.5, P < 0.001) but more frequently suffered from tuberculosis (2.5% vs. 0%, P = 0.01) and more frequently had never been medically examined before ICU admission (10.8% vs. 0%, P < 0.001). Admission diagnoses differed both in type and relative proportions in the two ICUs (P < 0.001). Admission of MonICU patients was more frequently unplanned (69% vs. 50.2%, P < 0.001), and although disease was more severe in these patients they received fewer therapeutic interventions than the AutICU patients. Overall mortality was higher in the MonICU patients (19.7 vs. 6.2%, P < 0.001). CONCLUSIONS:Patient characteristics and ICU practices varied significantly between the two ICUs. Mortality was substantially greater at MonICU, particularly among patients suffering from multiple-organ dysfunction. Strategies to improve the care of critically illpatients at MonICU should address both system- and staff-related problems, improve acceptance of the ICU service among physicians of other disciplines and upgrade the training of ICU staff.
Authors: Stefan Jochberger; Feruza Ismailova; Wolfgang Lederer; Viktoria D Mayr; Günter Luckner; Volker Wenzel; Hanno Ulmer; Walter R Hasibeder; Martin W Dünser Journal: Anesth Analg Date: 2008-03 Impact factor: 5.108
Authors: Jeremy M Kahn; Christopher H Goss; Patrick J Heagerty; Andrew A Kramer; Chelsea R O'Brien; Gordon D Rubenfeld Journal: N Engl J Med Date: 2006-07-06 Impact factor: 91.245
Authors: Larry McNicol; David A Story; Kate Leslie; Paul S Myles; Michael Fink; Andrew C Shelton; Ornella Clavisi; Stephanie J Poustie Journal: Med J Aust Date: 2007-05-07 Impact factor: 7.738
Authors: Otgon Bataar; Ganbold Lundeg; Ganbat Tsenddorj; Stefan Jochberger; Wilhelm Grander; Inipavudu Baelani; Iain Wilson; Tim Baker; Martin W Dünser Journal: Bull World Health Organ Date: 2010-05-28 Impact factor: 9.408
Authors: Marcus J Schultz; Martin W Dunser; Arjen M Dondorp; Neill K J Adhikari; Shivakumar Iyer; Arthur Kwizera; Yoel Lubell; Alfred Papali; Luigi Pisani; Beth D Riviello; Derek C Angus; Luciano C Azevedo; Tim Baker; Janet V Diaz; Emir Festic; Rashan Haniffa; Randeep Jawa; Shevin T Jacob; Niranjan Kissoon; Rakesh Lodha; Ignacio Martin-Loeches; Ganbold Lundeg; David Misango; Mervyn Mer; Sanjib Mohanty; Srinivas Murthy; Ndidiamaka Musa; Jane Nakibuuka; Ary Serpa Neto; Mai Nguyen Thi Hoang; Binh Nguyen Thien; Rajyabardhan Pattnaik; Jason Phua; Jacobus Preller; Pedro Povoa; Suchitra Ranjit; Daniel Talmor; Jonarthan Thevanayagam; C Louise Thwaites Journal: Intensive Care Med Date: 2017-03-27 Impact factor: 17.440
Authors: Naranpurev Mendsaikhan; Tsolmon Begzjav; Ganbold Lundeg; Andreas Brunauer; Martin W Dünser Journal: PLoS One Date: 2016-08-17 Impact factor: 3.240