6.6 6.5 Malaysia Registry of Intensive Care 2015
85
Figure 27 : Pressure ulcers, by individual hospital 2015
0.7 1.1
1.1 1.1
1.1 1.2
1.2 1.4
1.4 1.5
1.7 1.7
1.7 1.9
2.1 2.4
2.8 3
3 3.1
3.7 4.1
4.1 4.4
4.5 4.5
4.7 5
5.3 5.7
6.7 7.6
7.6 7.6
7.9 8.8
9.5 10.1
10.2 11.6
11.8 13.1
13.1 13.5
15.9 17.8
18.3
2 4
6 8
10 12
14 16
18 20
KEM KT
SMJ KJG
LKW MUR
SBN MLK
TML KLP
PJY BP
KEN TI
TM PD
TPG SLR
KGR KLG
SJ AMP
KB AS
BIN DKS
SDG SGT
KL KLM
SB KKR
IPH KCH
KP SP
SI LAB
TW SLG
KK PP
BM KTN
LD SBL
JB LIK
MRI
Pressure ulcer per 1000 ICU days
86
SECTION E:
MORTALITY OUTCOMES
1. ICU outcome 2. Hospital outcome
3. Crude in-ICU mortality 4. Crude in-hospital mortality
5. Standardised mortality ratio
87
Crude mortality rates are convenient measures of outcome. However, they are poor indicators of performance of intensive care as they do not take into account variations in
patient characteristics such as case mix and the severity of illness.
A better measure of ICU performance is standardised mortality ratio SMR, comparing the observed to the predicted mortality, using a severity scoring system. SMR stratifies patients
according to the severity of illness. SMR of more than one indicates that the actual number of deaths is more than the predicted number of deaths and vice versa.
When interpreting SMR values, one must take into consideration factors which affect the severity scoring system used to predict mortality. These include interval between onset of
illness to ICU admission lead time bias, post-ICU care and small sample size. Lead-time bias refers to the erroneous estimation of risk at the time of admission to the ICU due to the
results of therapeutic actions taken previously. Table 37 :
ICU outcome, by category of ICU 2015
ICU outcome ICUs
Adm 1000 n
Adm 500 - 999 n
Adm 500 n
UMMC n
Total n
Alive 19812
80.5 5923
77.6 4745
78.6 1038
80.2
31518 79.6
Died 4474
18.2 1511
19.8 1009
16.7 241
18.6
7235 18.3
Discharged with grave
prognosis 171
0.7 83
1.1 93
1.5 11
0.9
358 0.9
Transfer to another
hospital 169
0.7 120
1.6 191
3.2 4
0.3
484 1.2
Total 24626
100 7637
100 6038
100 1294
100 39595
100
Table 38 : Hospital outcome, by category of ICU 2015
Hospital outcome
ICUs Adm 1000
n Adm 500 - 999
n Adm 500
n UMMC
n Total
n
Alive 17365
70.5 5217
68.3 4385
72.6 923
71.3
27890 70.4
Died 6167
25.0 2009
26.3 1276
21.1 333
25.7
9785 24.7
Discharged with grave
prognosis 314
1.3 108
1.4 120
2.0 33
2.6
575 1.5
Transfer to another
hospital 780
3.2 303
4.0 257
4.3 5
0.4
1345 3.4
Total 24626
100.0 7637
100 6038
100 1294
100 39595
100
88
Table 39 : Crude in-ICU and in-hospital mortality rate, by individual hospital
2011
– 2015
Hospital Crude in-ICU mortality in-hospital mortality
2011 2012
2013 2014
2015
AS 24.1 34.4
26.7 44.5 27.3 37.3
28.9 39.7 25.4 41.7
PP 14.4 23.3
16.5 26.9 15.6 25.0
18.3 25.7 19.7 29.6
IPH 22.4 30.0
16.5 25.5 18.5 25.6
16.7 24.7 20.1 29.2
KL 17.0 24.7
18.4 27.0 17.5 25.8
14.3 21.9 18.1 25.2
SLG 17.9 25.8
16.5 27.1 17.2 24.5
15.7 20.8 16.2 21.0
KLG 17.1 25.1
15.5 22.9 13.6 21.7
13.3 19.3 15.7 20.2
SBN 21.3 30.0
22.1 30.4 19.7 25.7
21.1 27.9 18.5 26.4
MLK 23.6 32.7
13.5 32.1 19.9 28.2
20.0 27.7 20.0 26.5
JB 22.3 31.4
21.4 30.0 22.2 29.9
17.4 25.5 20.3 28.2
KTN 17.2 24.3
24.1 34.9 22.2 32.2
17.8 25.5 21.3 28.6
KT 20.9 27.2
18.5 28.1 22.0 32.0
21.0 30.0 17.9 25.3
KB 17.8 24.4
16.0 22.6 15.0 21.3
11.6 16.1 13.1 23.5
KCH 22.1 29.1
17.4 24.3 18.0 24.0
13.9 17.7 16.4 23.2
KK 20.5 27.3
21.7 34.0 19.5 25.3
17.2 22.5 15.7 23.0
SP 32.6 42.2
26.9 38.4 23.3 32.6
22.8 30.4 17.6 24.5
PJY 18.4 21.9
16.9 19.3 19.9 22.9
15.9 19.6 14.4 17.9
MUR 20.9 29.2
24.1 33.8 20.7 24.7
24.2 26.2 22.4 28.8
TI 22.4 35.1
17.7 31.9 21.9 34.6
23.4 34.7 21.9 27.4
TPG 27.0 43.4
21.4 35.3 19.3 30.1
20.9 28.8 20.0 31.8
SJ 25.2 35.2
23.2 35.5 29.3 40.2
24.2 28.4 17.7 19.6
KJG 19.6 27.0
15.0 23.8 15.9 26.8
12.0 21.1 13.9 21.0
KGR 18.1 25.8
16.3 22.1 18.0 24.5
17.0 17.3 18.4 21.3
TML 19.7 23.0
14.7 21.0 16.0 22.5
19.1 25.7 20.1 27.5
KP 34.3 47.1
28.9 42.4 28.7 38.0
`30.5 37.1 25.8 33.5
SMJ 24.5 33.2
24.3 29.6 27.6 32.7
30.1 36.1 17.9 25.1
BP 21.4 32.6
29.8 40.7 22.7 31.0
20.0 34.6 16.1 28.0
TW 15.7 27.0
13.7 24.3 17.8 29.6
16.3 23.7 15.2 21.2
MRI 22.6 29.6
18.3 24.1 18.7 22.0
15.4 16.8 24.7 25.9
KLM 30.9 40.2
21.0 32.5 25.8 39.0
26.5 40.0 23.7 34.9
SDG 18.0 22.9
17.7 25.9 18.3 26.3
16.6 22.6 18.7 23.6
SB 24.3 31.8
22.8 30.2 24.9 39.5
27.1 35.3 16.0 24.3
DKS 27.8 30.2
25.5 26.8 26.9 31.3
22.3 31.5 18.6 25.1
SI 22.1 28.7
24.6 28.6 21.2 26.5
20.2 26.1 19.1 26.2
SBL 18.0 28.5
17.2 25.2 18.6 26.9
18.7 24.1 18.0 24.5
AMP 35.1 43.9
37.9 47.8 31.1 42.1
35.6 44.0 33.9 43.7
LIK 2.9 3.7
5.6 6.5 4.1 6.0
2.3 4.0 6.5 7.3
LKW -
28.6 36.2 17.8 22.3
26.1 33.3 25.9 31.9
BM -
13.2 21.1 29.8 34.8
19.9 22.2 23.9 35.1
SLR -
42.8 52.6 27.6 31.1
32.7 39.0 35.3 42.9
PD -
14.6 18.4 15.9 23.0
15.5 20.0 15.5 17.0
KKR -
15.0 24.4 23.7 28.7
21.5 21.5 13.7 15.9
89
SGT -
24.5 30.4 21.4 34.5
18.0 25.3 19.1 23.5
TM -
5.9 11.8 23.7 24.4
22.5 24.4 15.1 18.2
KEM -
9.9 12.6 15.3 17.1
13.2 23.1 10.2 18.9
KLP -
0 0 8.6 11.2
12.5 14.6 7.1 9.2
LAB -
29.7 34.3 35.7 40.0
40.4 43.4 20.9 24.8
KEN -
11.4 20.0 6.8 12.4
9.7 12.5 6.0 10.4
BIN -
17.8 27.7 12.7 17.7
14.5 19.8 13.7 22.3
LD -
29.8 38.1 23.0 35.3
29.5 40.6 15.4 28.8
MOH Hospitals 21.2 29.5