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  1. Evaluation de nouvelles modalités de prescription du bilan hépatique en réanimation.

    Article - En français

    Traduction en anglais : Evaluation of new guidelines for liver function tests ordering in the ICU.

    Objective 

    To determine whether a new protocol for ordering liver function tests could decrease their number, and consequently the costs.

    Design 

    This orospective study was conducted between October and November 1996, with October-November 1995 as the baseline period.

    According to the new guidelines, at admission to the ICU total and conjugated bilirubin, aspartate alanine transferase, and aspartate amino transferase were ordered as usual ; alkaline phosphatase and gamma glutamyl transpeptidase were ordered only in particular situations.

    Subsequently, aspartate amino transferase and conjugated bilirubin were not ordered systematically.

    Setting 

    A17 bird medical ICU in a tertiary university hospital.

    Patients 

    All patients admitted to the ICU during both periods.

    Main outcome measurements 

    Impact of the new guidelines on the number of the liver function tests ordered in 1996.

    Results 

    1) The clinical characteristics of both populations were similar. 2) The number of each liver function test ordered per patient per day was lower in 1996 vs. 1995 (P<0.005). 3) The AST/ALT ratio was lower in 1996 vs. 1995 (0.87 ± 0.4 vs. 1.0±0.7, P=0.001) ; the Bill C/Bili T ratio was also lower in 1996 (0.6±0.4 vs. 1.0±0.1, P=0.001). 4) Regardless of the severity of the illness, the overall number of each liver function test was lower in 1996.

    In the absence of hepatic failure, fewer liver tests were ordered (P<0.05). (...)

    Mots-clés Pascal : Bilan, Fonction hépatique, Analyse avantage coût, Unité soin intensif, Prescription médicale, Indication, Recommandation, Homme, Foie, Appareil digestif, Economie santé

    Mots-clés Pascal anglais : Balance, Liver function, Cost benefit analysis, Intensive care unit, Medical prescription, Indication, Recommendation, Human, Liver, Digestive system, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0364117

    Code Inist : 002B24J. Création : 14/12/1999.