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

• 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
• ISSN: 0972-5229; 1998-359X
• DOI: 10.4103/0972-5229.33387

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