Harrison David A, Brady Anthony R, Rowan Kathy
Intensive Care National Audit & Research Centre, London, UK.
Crit Care. 2004 Apr;8(2):R99-111. doi: 10.1186/cc2834. Epub 2004 Feb 26.
The present paper describes the methods of data collection and validation employed in the Intensive Care National Audit & Research Centre Case Mix Programme (CMP), a national comparative audit of outcome for adult, critical care admissions. The paper also describes the case mix, outcome and activity of the admissions in the Case Mix Programme Database (CMPD).
The CMP collects data on consecutive admissions to adult, general critical care units in England, Wales and Northern Ireland. Explicit steps are taken to ensure the accuracy of the data, including use of a dataset specification, of initial and refresher training courses, and of local and central validation of submitted data for incomplete, illogical and inconsistent values. Criteria for evaluating clinical databases developed by the Directory of Clinical Databases were applied to the CMPD. The case mix, outcome and activity for all admissions were briefly summarised.
The mean quality level achieved by the CMPD for the 10 Directory of Clinical Databases criteria was 3.4 (on a scale of 1 = worst to 4 = best). The CMPD contained validated data on 129,647 admissions to 128 units. The median age was 63 years, and 59% were male. The mean Acute Physiology and Chronic Health Evaluation II score was 16.5. Mortality was 20.3% in the CMP unit and was 30.8% at ultimate discharge from hospital. Nonsurvivors stayed longer in intensive care than did survivors (median 2.0 days versus 1.7 days in the CMP unit) but had a shorter total hospital length of stay (9 days versus 16 days). Results for the CMPD were comparable with results from other published reports of UK critical care admissions.
The CMP uses rigorous methods to ensure data are complete, valid and reliable. The CMP scores well against published criteria for high-quality clinical databases.
本文描述了重症监护国家审计与研究中心病例组合项目（CMP）中所采用的数据收集和验证方法，该项目是一项针对成人重症监护入院患者结局的全国性比较审计。本文还描述了病例组合项目数据库（CMPD）中入院患者的病例组合、结局和活动情况。
CMP收集英格兰、威尔士和北爱尔兰成人普通重症监护病房连续入院患者的数据。采取明确步骤确保数据的准确性，包括使用数据集规范、开展初始培训课程和进修培训课程，以及对提交数据中不完整、不合逻辑和不一致的值进行本地和中央验证。将临床数据库目录制定的临床数据库评估标准应用于CMPD。简要总结了所有入院患者的病例组合、结局和活动情况。
CMPD在临床数据库目录的10项标准上达到的平均质量水平为3.4（范围为1 =最差至4 =最佳）。CMPD包含了128个病房129,647例入院患者的经过验证的数据。年龄中位数为63岁，男性占59%。急性生理与慢性健康状况评估II（APACHE II）评分的平均值为16.5。CMP病房的死亡率为20.3%，出院时的最终死亡率为30.8%。非幸存者在重症监护病房的停留时间比幸存者长（CMP病房中中位数分别为2.0天和1.7天），但总住院时间较短（分别为9天和16天）。CMPD的结果与英国其他已发表的重症监护入院报告结果具有可比性。
CMP采用严格方法确保数据完整、有效且可靠。根据已发表的高质量临床数据库标准，CMP得分良好。
