Abstract
ABSTRACTContextThe Indian Society of Critical Care Medicine (ISCCM), had taken an initiative to enable all Indian ICUs (Intensive Care Unit) to capture and store relevant data in a systematic manner in an electronic database: “CHITRA” (Customized Health in Intensive Care Trainable Research and Analysis tool).AimsThis study was aimed at capturing, and summarising longitudinal epidemiological data from a single tertiary care hospital ICU (Intensive Care Unit), based on a pre-existing database and the CHITRA system.Settings and designProspective ObservationalMaterials and methodsData was extracted from two databases, a pre-existing database, arbitrarily named pre-CHITRA (January 2006 to April 2014), and the CHITRATM database (October 2015 to January 2018). Diagnoses of the patients admitted were tabulated using the ICD10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision) coding format. The outcomes were summarised and cross tabulated.Statistical analysis usedCross tabulations were used to display summarized data, analysis of outcomes were done using t test and regression analyses, and correspondence analysis was used to explore associations of descriptors.ResultsA total of 18940 patients were admitted, with a male preponderance, and the median age was fifty-two years. Most of admissions were from emergency (62%). The age (0.3, p = 0.000, CI (0.2 - 0.38)) and mean APACHE II score of patients had increased over the years (0.18, p = 0.000 CI (0.12-0.25). The ICU mortality had decreased significantly over the years (–0.04, p = 0.000, CI (–0.05 to –0.03)). The most common admission diagnosis in the pre-CHITRA database was general symptoms and signs (ICD10 R50-R69), and in the CHITRA database was Type1 Respiratory failure (ICD 10 J96.90).ConclusionThis study has shown the utility of the CHITRA system in capturing epidemiological data from a single centre.Key messagesThe utility of the CHITRA system in capturing epidemiological data has been shown.How to cite this articleManu Varma MK, Krishna B, Sampath S. Secular Trends in an Indian Intensive Care Unit-Database Derived Epidemiology: The Stride Study. Indian J Crit Care Med 2019;23(6):251–257.
Highlights
The practice and services provided by intensive care units (ICUs) vary across and within the countries.1 Patients in differentIntensive Care Unit (ICU) can exhibit substantial variations in comorbidities, casemix, and severity of illness scores
This study has shown the utility of the CHITRA system in capturing epidemiological data from a single centre
Current available epidemiological studies from Indian ICUs are restricted to multicentre cross-sectional studies or descriptive studies pertaining to specific subgroups of patients
Summary
The practice and services provided by intensive care units (ICUs) vary across and within the countries. Patients in differentICUs can exhibit substantial variations in comorbidities, casemix, and severity of illness scores. The practice and services provided by intensive care units (ICUs) vary across and within the countries.. ICUs can exhibit substantial variations in comorbidities, casemix, and severity of illness scores. In ICUs, secular variations in patient population and severity of illness are not unexpected.. Longitudinal epidemiological studies can be utilized to assess and quantify the impact of changes in healthcare delivery.. Studies have compared mortality among gender and different age groups.. A time series analysis in United States ICU from 1988 to 2012 showed mortality reduction accompanied by an increase in severity of illness and chronic health conditions.. Current available epidemiological studies from Indian ICUs are restricted to multicentre cross-sectional studies or descriptive studies pertaining to specific subgroups of patients. Studies have compared mortality among gender and different age groups. A time series analysis in United States ICU from 1988 to 2012 showed mortality reduction accompanied by an increase in severity of illness and chronic health conditions. Current available epidemiological studies from Indian ICUs are restricted to multicentre cross-sectional studies or descriptive studies pertaining to specific subgroups of patients.
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