TY - JOUR
T1 - Implementing an intensive care registry in India: Preliminary results of the case-mix program and an opportunity for quality improvement and research
AU - Tirupakuzhi Vijayaraghavan, Bharath Kumar
AU - Adhikari, Neill K. J.
AU - Arali, Rajeshwari
AU - Attanayake, Udara
AU - Balasundaram, Sampath
AU - Beane, Abi
AU - Chakravarthy, Vijay
AU - Channanath Ashraf, Niyaz
AU - Darshana, Sri
AU - Devaprasad, Dedeepiya
AU - Dondorp, Arjen M.
AU - Fowler, Robert
AU - Haniffa, Rashan
AU - Ishani, Pramodya
AU - James, Augustian
AU - Jawad, Issrah
AU - Jayakumar, Devachandran
AU - Kodipilly, Chamira
AU - Laxmappa, Rakesh
AU - Mangal, Kishore
AU - Mani, Ashwin
AU - Mathew, Meghena
AU - Patodia, Sristi
AU - Pattnaik, Rajyabardhan
AU - Priyadarshini, Dilanthi
AU - Pulicken, Mathew
AU - Rabindrarajan, Ebenezer
AU - Ramachandran, Pratheema
AU - Ramesh, Kavita
AU - Rani, Usha
AU - Ranjit, Suchitra
AU - Ramaiyan, Ananth
AU - Ramakrishnan, Nagarajan
AU - Ranganathan, Lakshmi
AU - Rashan, Thalha
AU - Dominic Savio, Raymond
AU - Selva, Jaganathan
AU - Tripathy, Swagata
AU - Tolppa, Timo
AU - Udayanga, Ishara
AU - Venkataraman, Ramesh
AU - Vijayan, Deepak
PY - 2020
Y1 - 2020
N2 - Background: The epidemiology of critical illness in India is distinct from high-income countries. However, limited data exist on resource availability, staffing patterns, case-mix and outcomes from critical illness. Critical care registries, by enabling a continual evaluation of service provision, epidemiology, resource availability and quality, can bridge these gaps in information. In January 2019, we established the Indian Registry of IntenSive care to map capacity and describe case-mix and outcomes. In this report, we describe the implementation process, preliminary results, opportunities for improvement, challenges and future directions. Methods: All adult and paediatric ICUs in India were eligible to join if they committed to entering data for ICU admissions. Data are collected by a designated representative through the electronic data collection platform of the registry. IRIS hosts data on a secure cloud-based server and access to the data is restricted to designated personnel and is protected with standard firewall and a valid secure socket layer (SSL) certificate. Each participating ICU owns and has access to its own data. All participating units have access to de-identified network-wide aggregate data which enables benchmarking and comparison. Results: The registry currently includes 14 adult and 1 paediatric ICU in the network (232 adult ICU beds and 9 paediatric ICU beds). There have been 8721 patient encounters with a mean age of 56.9 (SD 18.9); 61.4% of patients were male and admissions to participating ICUs were predominantly unplanned (87.5%). At admission, most patients (61.5%) received antibiotics, 17.3% needed vasopressors, and 23.7% were mechanically ventilated. Mortality for the entire cohort was 9%. Data availability for demographics, clinical parameters, and indicators of admission severity was greater than 95%. Conclusions: IRIS represents a successful model for the continual evaluation of critical illness epidemiology in India and provides a framework for the deployment of multi-centre quality improvement and context-relevant clinical research.
AB - Background: The epidemiology of critical illness in India is distinct from high-income countries. However, limited data exist on resource availability, staffing patterns, case-mix and outcomes from critical illness. Critical care registries, by enabling a continual evaluation of service provision, epidemiology, resource availability and quality, can bridge these gaps in information. In January 2019, we established the Indian Registry of IntenSive care to map capacity and describe case-mix and outcomes. In this report, we describe the implementation process, preliminary results, opportunities for improvement, challenges and future directions. Methods: All adult and paediatric ICUs in India were eligible to join if they committed to entering data for ICU admissions. Data are collected by a designated representative through the electronic data collection platform of the registry. IRIS hosts data on a secure cloud-based server and access to the data is restricted to designated personnel and is protected with standard firewall and a valid secure socket layer (SSL) certificate. Each participating ICU owns and has access to its own data. All participating units have access to de-identified network-wide aggregate data which enables benchmarking and comparison. Results: The registry currently includes 14 adult and 1 paediatric ICU in the network (232 adult ICU beds and 9 paediatric ICU beds). There have been 8721 patient encounters with a mean age of 56.9 (SD 18.9); 61.4% of patients were male and admissions to participating ICUs were predominantly unplanned (87.5%). At admission, most patients (61.5%) received antibiotics, 17.3% needed vasopressors, and 23.7% were mechanically ventilated. Mortality for the entire cohort was 9%. Data availability for demographics, clinical parameters, and indicators of admission severity was greater than 95%. Conclusions: IRIS represents a successful model for the continual evaluation of critical illness epidemiology in India and provides a framework for the deployment of multi-centre quality improvement and context-relevant clinical research.
KW - Critical care
KW - India
KW - Registries
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85096384106&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33195819
U2 - https://doi.org/10.12688/wellcomeopenres.16152.2
DO - https://doi.org/10.12688/wellcomeopenres.16152.2
M3 - Article
C2 - 33195819
SN - 2398-502X
VL - 5
JO - Wellcome open research
JF - Wellcome open research
M1 - 182
ER -