The utilities of the therapeutic intervention scoring system (TISS-28)

Background and Aims: The study evaluates the utility of therapeutic intervention scoring system (TISS-28) in quantifying the resource utilization, costs and predicting outcome of critically ill patients. Materials and Methods: TISS-28 was prospectively applied to patients consecutively admitted to t...

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Bibliographic Details
Published in:	Indian journal of critical care medicine Vol. 11; no. 2; pp. 61 - 66
Main Authors:	Hariharan, Seetharaman, Chen, Deryk, Merritt-Charles, Lorna, Bobb, Nahmorah, DeFreitas, Loren, Esdelle-Thomas, Joann Mohamed Andre, Charles, Delise, Colley, Karen, Renaud, Elise
Format:	Journal Article
Language:	English
Published:	New Delhi Medknow Publications on behalf of the Indian Society of Critical Care Medicine 01-04-2007 Medknow Publications and Media Pvt. Ltd Jaypee Brothers Medical Publishers Ltd
Subjects:	Critically ill Health aspects Homeopathy Intensive care units Intensive care units costs, resource utilization, therapeutic intervention scores Management Materia medica and therapeutics Patient outcomes Therapeutics India
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Summary:	Background and Aims: The study evaluates the utility of therapeutic intervention scoring system (TISS-28) in quantifying the resource utilization, costs and predicting outcome of critically ill patients. Materials and Methods: TISS-28 was prospectively applied to patients consecutively admitted to the intensive care units (ICU) of three public teaching hospitals and two private hospitals in Trinidad on a daily basis for a period of eight weeks. Demographic data, diagnoses on admission, nurse-patient ratio, ICU length of stay and hospital outcomes were recorded. Simplified acute physiology score (SAPS)-II was applied for all adult patients. Costs were calculated from data collected from the public hospitals in relation to TISS-28 score. Results : TISS-28 scores of five hundred and ninety-five patient-days were analyzed. The median daily TISS-28 per patient was 27 [24.5, 30.6 quartiles (IQR)]; the median day-1 TISS-28 score was 29 (25, 33 IQR) and the median last day TISS-28 score was 25 (21, 30 IQR). The overall average TISS per nurse was 26.2 per day. The mean cost per patient per day was 414 US dollars. The discriminatory function of day-1 TISS-28 as a prognostic scoring system was less compared to SAPS II as shown by the area under the receiver operating characteristic curve (0.65 compared to 0.71). Conclusions: TISS-28 is useful for evaluating the resource utilization and costs and may not be useful as a prognostic scoring system
ISSN:	0972-5229 1998-359X
DOI:	10.4103/0972-5229.33387