Serial measurement of Therapeutic Intervention Scoring System-28 (TISS-28) in a surgical intensive care unit |
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| Authors: | Norman Muehler Janaina Oishi Martin Specht Florian Rissner Konrad Reinhart Yasser Sakr |
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| Affiliation: | 1. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands;2. Department of Surgery, Rijnland Hospital, Leiderdorp, The Netherlands;3. Department of Surgery, Reinier de Graaff Group, Delft, The Netherlands;4. Department of Surgery, Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;5. Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands;1. Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA;2. Department of Epidemiology and Biostatistics, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, 44106-4945, USA;3. Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA;2. Centre for Clinical Epidemiology and Community Studies, Solidage-McGill University/Université de Montréal Research Group on Frailty and Aging, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada;3. Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada;1. Emergency Department and Intensive Care, University of Milan-Bicocca, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), Italy;2. Department of Experimental Medicine, University of Milan-Bicocca, Via Cadore 48, Monza (MB), Italy;1. Aix Marseille université, AP–HM, anaesthesia and intensive care medicine, hôpital Nord, chemin des Bourrely, 13015 Marseille, France;2. Department of perioperative medicine, university hospital of Clermont-Ferrand, 1, place Lucie-Aubrac, 63103 Clermont-Ferrand, France;3. Department of anaesthesia and intensive care, university hospital of Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France;4. Department of anaesthesiology and critical care medicine, hôpital universitaire Necker-Enfants-Malades, AP–HP, University Paris Descartes, 149, rue de Sèvres, 75743 Paris, France;5. Department of anaesthesia and intensive care, Magellan university hospital, 1, avenue de Magellan, 33600 Pessac, France;6. Multidisciplinary intensive care unit, department of anaesthesiology and critical care, hôpital de la Pitié-Salpêtrière, assistance publique-hôpitaux de Paris, Sorbonne université, 75013 Paris, France;7. Department of anaesthesia and intensive care, Saint-Louis hospital, 1, avenue Claude-Vellefaux, 75010 Paris, France;8. Department of anaesthesiology and critical care medicine, Amiens-Picardie university Hospital, 80054 Amiens, France;9. Department of anaesthesia and intensive care, Dijon university hospital, BP 77908, 21709 Dijon, France;10. Department of anaesthesia and intensive care, university hospital of Toulouse, university Toulouse 3 Paul Sabatier, 31000 Toulouse, France;11. Intensive care, anaesthesia, pain, emergency and intensive care department, centre hospitalier universitaire Carémeau, 30000 Nîmes, France;12. Medical surgical ICU, Pasteur 2 hospital, Nice university hospital, 30, voie Romaine, 06001 Nice, France;13. Assistance publique-hôpitaux de Paris, hôpital Tenon, department of anaesthesia and intensive care and perioperative medicine, groupe hospitalier des hôpitaux universitaires de l''Est Parisien, Sorbonne Université, 75020 Paris, France;14. Intensive care unit, anaesthesia and critical care department, Hôtel Dieu, university hospital of Nantes, 44000 Nantes, France;15. Clinique Pont De Chaume, 330, avenue Marcel Unal, 82000 Montauban, France;p. Department of anaesthesia and intensive care, Lapeyronie university hospital, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France;1. General Intensive Care Unit, Emergency Department – ASST Monza - San Gerardo Hospital, University of Milano-Bicocca, Via Pergolesi 33, Monza (MB), Italy;2. Anesthesia & Intensive Care Department, “Paolo Giaccone” University Hospital, Palermo, Italy;3. Medical & Surgical Intensive Care Unit, Careggi University Hospital, Florence, Italy |
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| Abstract: | PurposeThe aim of the study was to assess the use of the Therapeutic Intervention Scoring System-28 (TISS-28) in surgical intensive care unit (ICU) patients and the relationship of the score to the type of surgery, severity of illness, and outcome in these patients.Materials and MethodsProspectively collected data from all patients admitted to a postoperative ICU between March 1, 2004, and June 30, 2006, were analyzed retrospectively.ResultsA total of 6903 patients were admitted during the study period (63.5% male; mean age, 62.3 years) constituting 29 140 observation days. The mean Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA), and TISS-28 scores on the day of ICU admission were 36.9 ± 18.2, 5.8 ± 3.9, and 43.2 ± 10.8, respectively. The highest admission TISS-28 was observed in patients who underwent cardiothoracic surgery (47.7 ± 10.1), the lowest in neurosurgical patients (40 ± 9.6), and both declined during the 2 weeks after ICU admission; however, in trauma patients and those admitted after gastrointestinal surgery, TISS scores increased gradually after the first 2 to 5 days in the ICU. The TISS-28 score was moderately correlated to SAPS II (R2 = 0.42; P < .001) and SOFA score (R2 = 0.48; P < .001) throughout the ICU stay and was consistently higher in nonsurvivors than in survivors during the first 2 weeks in the ICU.ConclusionsThere are marked variations in TISS-28 scores according to the type of surgery. Therapeutic Intervention Scoring System-28 correlates with the severity of illness and outcome in these patients. |
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