Thursday, 4 December 2014

The ARCTIC Index: measuring quality of cardiothoracic admissions in ICUs

Seven researchers co-authored a paper to create and monitor an index titled as the Acute Risk Change for Cardiothoracic Admissions to Intensive Care (ARCTIC) which is used to measure cardiothoracic admissions into intensive care units.

The intention behind the study was to determine a better method of comparison surrounding the quality of surgical care for cardiac related admissions within hospitals. Due to the large number of patients, the index was to provide an alternative measure rather than mortality to distinguish between different medical institutions.

The data for the study was gathered due through two different databases ( The Australian and New Zealand Society of Cardiac and Thoracic Surgeons and the Australian and New Zealand Intensive Care Society Adult Patient Database). The use of logistic regression allowed the researchers to create a predicted risk of death utilising existing data. The variations of risk were calculated as an ARCTIC percentage for individual patients.

Through 21 hospitals, 16,687 patients were matched through the ARCTIC index. An increase of an ARCTIC percentage indicated prolonged cardiopulmonary bypass time, intraoperative blood product transfusion, reoperation, postoperative renal failure, prolonged ventilation, and stroke.

The conclusions drawn from this were that the ARCTIC index can be used to measure the overarching quality for cardiac operations across different hospitals. However, it is acknowledged that more extensive research is needed to determine to use the ARCTIC index to differentiate amongst cardiac surgical divisions.

Read the paper in full here:

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