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The influence of APACHE II score on the average noise level in an intensive care unit: an observational study.

Park M, Vos P, Vlaskamp BN, Kohlrausch A, Oldenbeuving AW - BMC Anesthesiol (2015)

Bottom Line: The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events.When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery.Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

View Article: PubMed Central - PubMed

Affiliation: Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands.

ABSTRACT

Background: Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients' well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score.

Methods: The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion.

Results: Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50% of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

Conclusions: Patient's initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.

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Related in: MedlinePlus

Results of the regression analysis. Regression lines are shown for A) APACHE II, B) room number and C) admission type for the individual data samples indicated as gray dots. Shaded areas indicate the 95- % confidence interval (band). All figures were produced by using visreg [29].
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Fig4: Results of the regression analysis. Regression lines are shown for A) APACHE II, B) room number and C) admission type for the individual data samples indicated as gray dots. Shaded areas indicate the 95- % confidence interval (band). All figures were produced by using visreg [29].

Mentions: Given the regression coefficients listed in Table 3, LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points. As shown in Figure 4(A), the APACHE II scores of the patients observed in the current study ranged from 9 to 34 points, for which the daily average noise level varied approximately from 50 to 53 dBA. Although it may be seen as a small difference, the 3-dBA increase in logarithmic scale is equivalent to a doubling of the acoustic energy (see the definition of LAeq,T in Endnotes), which may result from the doubling of the number (or the duration) of noisy events, thus potentially affecting the patient’s sleep/rest quality.Figure 4


The influence of APACHE II score on the average noise level in an intensive care unit: an observational study.

Park M, Vos P, Vlaskamp BN, Kohlrausch A, Oldenbeuving AW - BMC Anesthesiol (2015)

Results of the regression analysis. Regression lines are shown for A) APACHE II, B) room number and C) admission type for the individual data samples indicated as gray dots. Shaded areas indicate the 95- % confidence interval (band). All figures were produced by using visreg [29].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389973&req=5

Fig4: Results of the regression analysis. Regression lines are shown for A) APACHE II, B) room number and C) admission type for the individual data samples indicated as gray dots. Shaded areas indicate the 95- % confidence interval (band). All figures were produced by using visreg [29].
Mentions: Given the regression coefficients listed in Table 3, LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points. As shown in Figure 4(A), the APACHE II scores of the patients observed in the current study ranged from 9 to 34 points, for which the daily average noise level varied approximately from 50 to 53 dBA. Although it may be seen as a small difference, the 3-dBA increase in logarithmic scale is equivalent to a doubling of the acoustic energy (see the definition of LAeq,T in Endnotes), which may result from the doubling of the number (or the duration) of noisy events, thus potentially affecting the patient’s sleep/rest quality.Figure 4

Bottom Line: The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events.When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery.Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

View Article: PubMed Central - PubMed

Affiliation: Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands.

ABSTRACT

Background: Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients' well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score.

Methods: The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion.

Results: Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50% of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

Conclusions: Patient's initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.

Show MeSH
Related in: MedlinePlus