AB 78. Review of the cases and outcomes of patients hospitalized in a High Dependency Unit of a pulmonary department in the year 2011

Background: Assessment of patients and their outcomes in the 6-bed High Dependency Unit (HDU) of our Pulmonary Department in the year 2011.

Patients and methods: Retrospective study of patients’ records.

Results: A total of 158 patients, 101 men and 57 women, were hospitalized. The majority of the patients were referred from the Emergency Department (n=98), while from Intensive Care Unit (ICU) and other Departments and Hospitals were referred 35 and 25 respectively. 111 patients were discharged from HDU, 22 were sent to ICU, 4 to other clinics and 21 eventually died. For 70 patients the reason for referral was type I respiratory failure attributed to pneumonia in 26, pulmonary embolism in 6, various malignancies in 8 and massive hemoptysis in 7 patients. Other aetiologies associated with type I respiratory failure included bronchial asthma in 3, pulmonary fibrosis in 3, near-drowning in 2, pneumothorax in 1 and finally monitoring after ICU in 14 patients. For type II respiratory failure were managed a total of 88 patients, of whom 74 were treated for COPD, 12 for concomitant COPD and cardiac failure and finally 2 for decompensated obesity hypoventilation syndrome. 14 patients were hospitalized in our HDU for tracheostomy management, in which tracheostomy was successfully removed in 7 patients. 3 patients were eventually were sent back to ICU, 1 patient was discharged at home with tracheostomy and finally 3 patients died. In patients who died the diagnosis were malignancies in 8 patients, severe infections in 6, pulmonary fibrosis in 2 and end-stage COPD in 5 patients.

Conclusions: The contribution of HDU is very important for the management of critically ill patients from different categories of diseases. In general wards the intensive care standards recommended cannot be guaranteed, something that is crucial especially for ICU patients and patients with tracheostomy.