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PubMed1998

Prediction Intervals for Estimates of Site Index Based on Ecosystem Type

/ British Columbia has an ecosystem classification system that classifies sites into site series. Foresters commonly measure the productivity of these sites by their site index. In British Columbia, site index is defined as the height of a stand at breast height age 50 and is usually estimated from height-age models. Biogeoclimatic site series/site index relationships are an increasingly popular method of estimating site index in British Columbia for stands where site index cannot be reliably estimated with height-age models. The precision of the predicted site index from these relationships can be evaluated with prediction intervals. This is done for the predicted site index of a single site, a group of sites, or the areally weighted site index of a group of sites. The methodology is also useful in determining the number of sites required to meet a specified precision. These prediction intervals will assist foresters in making sound forest management decisions.KEY WORDS: Biogeoclimatic Ecosystem Classification; Precision; Prediction interval; Site index; Site series

Journal Article↗
PubMed1986

The hemodynamic determinants of the isovolumic index.

The isovolumic index is a recently described echocardiographic parameter of left ventricular function that is calculated as the ratio between the sum of the time of isovolumic contraction and relaxation divided by the ejection time. Although the individual components of this index may be altered by heart rate and loading conditions, an analysis of the net effect of such alterations on the isovolumic index has not been undertaken. Thus, dogs were instrumented with high-fidelity micromanometers in the left ventricle, ascending aorta, and left atrium to allow determination of the individual components of the isovolumic index and calculation of the index itself. Four sets of experiments were undertaken in random order. Left atrial pacing was used to increase heart rate by approximately 10 bpm in five steps. Preload was elevated in five stages by saline infusions which caused successive increases of 1 to 2 mm Hg in the left ventricular end-diastolic pressure. Systolic blood pressure was lowered or raised by approximately 10 mm Hg per stage by three progressive, steady-state infusions of nitroprusside and phenylephrine, respectively. These experiments demonstrated little change in the isovolumic index over a broad range of heart rate. Increased left ventricular end-diastolic pressure and decreased systemic pressure caused shortening of the index. Multiple regression analysis of all experiments yielded the following: isovolumic index = 0.41 - 0.015 (left ventricular end-diastolic pressure) + 0.004 (systolic blood pressure); r = 0.57, standard error = 0.13, p less than 0.0001. Therefore, this investigation establishes the hemodynamic determinants of the isovolumic index and provides the basis for interpretation of directional changes in response to cardiac diseases and cardioactive drugs that can alter loading conditions.

Animals↗
PubMed1981

Radionuclide regurgitant index: value and limitations.

The radionuclide regurgitant index, defined as left ventricular/right ventricular stroke counts obtained from gated equilibrium studies, has been reported to predict the presence and severity of left-sided valve regurgitation. This study evaluated the radionuclide regurgitant index in 100 patients in whom left-sided valve regurgitation was angiographically graded (0 to 4+) with regard to most severe mitral or aortic regurgitation. Regurgitation was graded 0 in 44 of the 100 patients, 1+ in 22, 2+ in 8, 3+ in 6 and 4+ in 20. The radionuclide regurgitant index was 0.9 to 1.5 in 51 patients, 1.6 to 2.4 in 23 and 2.5 to 12.0 in 26. The mean radionuclide regurgitant index was 1.34 in the group with no regurgitation and 1.60 in those with 1+, 2.01 in those with 2+, 2.80 in those with 3+ and 3.85 in those with 4+ regurgitation. There was a significant difference (p less than 0.05) in the radionuclide regurgitant index between patients with no regurgitation and each group with regurgitation and between groups with regurgitation separated by two or more grades of angiographic regurgitation. Twelve patients had a discordant radionuclide regurgitant index; their index either predicted clinically significant or severe regurgitation when they had no or trivial regurgitation, or predicted no or trivial regurgitation when they had clinically significant regurgitation. Eight of 10 patients with a left ventricular ejection fraction of less than 0.30 had a discordant index (p less than 0.0005). All three patients with mitral valve prolapse associated with frequent ventricular extrasystoles had a discordant index (p less than 0.0005).

Adolescent↗
PubMed1990

A bleeding risk index for estimating the probability of major bleeding in hospitalized patients starting anticoagulant therapy.

PURPOSE: To construct and test prospectively a bleeding risk index for estimating the probability of major bleeding in hospitalized patients starting long-term anticoagulant therapy. PATIENTS AND METHODS: In an inception cohort of 617 patients starting long-term anticoagulant therapy in one hospital, data were gathered retrospectively and bleeding was classified using reliable explicit criteria. We constructed a bleeding risk index by identifying and weighting independent predictors of major bleeding using a multivariate proportional-hazards model. The bleeding risk index was tested in 394 other patients prospectively identified in a second hospital. The index was compared to physicians' predictions. RESULTS: Major bleeding developed before discharge in 61 of all 1,011 patients (6%). The bleeding risk index included four independent risk factors for major in-hospital bleeding: the number of specific comorbid conditions; heparin use in patients aged 60 years or older; maximal prothrombin or partial thromboplastin time 2.0 or more times control; liver dysfunction worsening during therapy. In the testing group, the index predicted major bleeding, which occurred in 3% of 235 low-risk patients, 16% of 96 middle-risk patients, and 19% of 63 high-risk patients (p less than 0.001). The bleeding risk index performed as well as physicians' predictions, and integration of the bleeding risk index with physicians' predictions led to a classification system that was more sensitive (p = 0.03) than physicians' predictions alone. In 86% of patients with a high risk of major bleeding, we identified specific ways of improving therapy, e.g., avoiding overanticoagulation and nonsteroidal anti-inflammatory agents. CONCLUSION: The bleeding risk index provides valid estimates of the probability of major bleeding in hospitalized patients starting long-term anticoagulant therapy and complements physicians' predictions. The possibility that bleeding can be prevented in high-risk patients warrants prospective evaluation.

Aged↗
PubMed1995

The equivalent refractive index of the crystalline lens in childhood.

Despite the importance of crystalline lens power in ocular development, schematic refractive index values used to calculate lens power have been validated for children. We measured refractive error and ocular component dimensions in 519 schoolchildren, calculating lens power using phakometrically measured lens radii and three different refractive index profiles: (1) Gullstrand-Emsley schematic indices [Gullstrand-Emsley lens power (GELP)]; (2) a 10-shell gradient index model [gradient index lens power (GILP)]; and (3) the equivalent refractive index (IND) needed to bring calculated and measured refractive error into agreement [calculated lens power (CLP)]. GELP was significantly lower than either GILP or CLP, indicating the Gullstrand-Emsley refractive index of 1.416 is too low for use in children. Variation in IND cannot be explained by measurement error alone. GILP and CLP also differed as a function of lens shape, with GILP greater than CLP at steeper external curvatures and less than CLP at flatter external curvatures. Variation in equatorial gradient index profile as a function of lens shape is proposed as an explanation for this bias. Equivalent index appears to be a useful tool for encompassing individual variation in lens gradient profiles as well as for assessing the relative role of lens surface curvature and refractive index changes during lens power development in childhood.

Adolescent↗
PubMed1995

The validity of using health state indexes in measuring the consequences of traffic injury for public health.

This paper describes an assessment of the validity of using health state indexes as a means of describing the consequences of traffic injury for public health. Three issues are discussed: (1) Can questionnaire data be used as input for estimating health state values by means of health state indexes? (2) Can the validity of describing the consequences of traffic injury by means of different health state indexes (QALY-indexes) be assessed? (3) Can estimated health state values be used directly as a basis for decision making? It is concluded that questionnaire data can be used as input of health state value estimation. Four health state indexes are compared: The Quality of Well Being Scale, The McMaster Health Classification System, The Rosser and Kind Index and the EuroQol Instrument (transformed version). It is concluded that an assessment of the validity of these indexes is possible, and that the EuroQol Instrument appears to be the most valid of the four indexes that are compared. None of the four indexes give values that are consistent with public policy objectives, but objectives were not set with the benefit of knowing the relative utility loss associated with injuries at different levels of severity.

Accidents, Traffic↗
PubMed1995

Cardiac index quantification by Doppler ultrasound in patients without left ventricular outflow tract abnormalities.

OBJECTIVES: We attempted to ascertain whether cardiac index can be directly estimated from Doppler mean velocity. BACKGROUND: Although diverse Doppler echocardiographic methods have been described for cardiac output quantification, they are not widely used in clinical practice. Cross-sectional area measurement has been identified as the main source of error in flow volume quantification. METHODS: A three-phase study by Doppler echocardiography was conducted in 306 patients. In phase I, the normal mean velocity ratio of the left and right ventricular outflow tracts was established in 170 normal subjects. In phase II, cardiac index, calculated as the product of aortic annular area index by mean velocity (conventional method), and mean velocity determined in the left ventricular outflow tract and ascending aorta by pulsed and continuous wave Doppler, respectively, were correlated with thermodilution cardiac index in 66 patients. In phase III, the accuracy of the regression equations obtained was prospectively assessed in an additional 70 patients. RESULTS: The normal left/right ventricular outflow tract mean velocity ratio by pulsed wave Doppler was 1.1 +/- 0.1. Cardiac index (CI) calculated by the conventional method and thermodilution (TD) showed acceptable correlation (r = 0.90, CITD = 1.20 CIPWD + 357; r = 0.86, CITD = 0.90 CICWD + 262) for pulsed (PWD) and continuous wave (CWD) Doppler, respectively, but with systematic underestimation (-28 +/- 13%, p < 0.01) by pulsed wave Doppler. Mean velocity (MV) showed excellent correlation with the thermodilution cardiac index (r = 0.97, CITD = 172 MVPWD - 172; r = 0.93, CITD = 129 MVCWD - 255). When these regression equations were prospectively applied, better agreement with the thermodilution cardiac index was obtained by pulsed wave Doppler directly from mean velocity (SD 240 ml/min per m2) than when aortic annular area was considered in the calculation (SD 428 ml/min per m2). Similar results were obtained by continuous wave Doppler (SD 433 vs. 599 ml/min per m2) but with less accuracy. CONCLUSIONS: Left ventricular outflow tract mean velocity determined by pulsed wave Doppler permits easy, accurate cardiac index quantification in the absence of left ventricular outflow abnormalities. The simplicity of this method enhances its clinical applicability in noninvasive monitoring of cardiac index.

Adolescent↗
PubMed2005

The relationship between an aortic isthmus blood flow velocity index and the postnatal neurodevelopmental status of fetuses with placental circulatory insufficiency.

OBJECTIVE: The purpose of this study was to evaluate the association between an abnormal aortic isthmus blood flow index and postnatal neurodevelopmental outcome in fetuses with placental circulatory insufficiency. STUDY DESIGN Forty-eight children who were born between 1991 and 1999 were included in this study on the basis of abnormal umbilical artery Doppler velocimetry. Prenatal isthmus blood flow index was obtained by dividing the sum of the systolic and diastolic Doppler blood flow velocity integrals by the systolic blood flow integrals. Neurodevelopmental outcome between 2 and 5 years was classified as optimal, when neurologic assessment and developmental quotient were within normal limits and as nonoptimal when abnormal neurologic findings and/or a nonoptimal developmental quotient was present. Neurodevelopmental outcome was analyzed in relation to isthmus flow index and pulsatility indices in the umbilical artery. RESULTS: The mean gestational age at delivery was 33.0 +/- 2 weeks. Nonoptimal neurodevelopmental outcome was found in 60.4% of the children (29/48). An inverse correlation was found between the isthmus blood flow index and postnatal neurodevelopmental outcome. All 13 children with an isthmus blood flow index of <0.5 were in the nonoptimal group. All 19 children with an optimal outcome had an isthmus blood flow index of >0.5, but this was also the case for 16 other children with nonoptimal neurodevelopmental outcome. An isthmus blood flow index cut-off value of 0.70 was associated with the highest overall positive and negative predictive values. The pulsatility index in the umbilical artery did not provide any significant contribution in the explanation of the outcome. CONCLUSION: The isthmic blood flow index can help to identify a subgroup of fetuses with placental circulatory insufficiency that might benefit from early delivery.

Aorta, Thoracic↗
PubMed2004

Noninvasive estimation of impaired hemodynamics for patients with acute myocardial infarction by Tei index.

BACKGROUND: Tei index, defined as the sum of isovolumic contraction and relaxation times divided by ejection time, has been proposed to express global left ventricular function. For patients with acute myocardial infarction (AMI), left ventricular function can potentially be a major determinant of hemodynamics with limited time for compensation, such as increased brain natriuretic peptide to attenuate congestion, and usually without any intervention to modify cardiac loading on arrival at the hospital during the acute phase. We, therefore, hypothesized that left ventricular function, expressed by the Tei index, allows noninvasive estimation of impaired hemodynamics for patients with AMI. METHODS: We studied 86 consecutive patients with first AMI (34 inferoposterior and 52 anteroseptal). Tei index was obtained as: (a - b)/b, where a is the interval between the cessation and onset of mitral flow and b is the ejection time by aortic flow by pulsed Doppler echocardiography. By using pulmonary capillary wedge pressure (PCWP) > or = 18 mm Hg or <18 mm Hg and cardiac index (CI) < or = 2.2 L/min/m(2) or > 2.2 L/min/m(2) by consecutive catheterization, patients were classified into 4 subsets: subset I with normal hemodynamics; subset II with elevated PCWP; subset III with reduced CI; and subset IV with both elevated PCWP and reduced CI. RESULTS: For patients with inferoposterior AMI, there was no significant correlation between the Tei index and PCWP or CI. For patients with anteroseptal AMI, however, the Tei index showed significant correlation both with PCWP (r = 0.59, P <.0001) and CI (r = -0.42, P <.01). Diagnosis of impaired hemodynamics (subset II-IV) by a Tei index > or = 0.60 showed a sensitivity, specificity, and accuracy of 86%, 82%, and 83%, respectively. CONCLUSIONS: Although the Tei index has limitations to evaluate hemodynamics in patients with inferoposterior AMI, the index allows approximate but quick and practical noninvasive estimation of impaired hemodynamics in patients with anteroseptal AMI.

Adult↗
PubMed2004

Population-based health indexes: a systematic review.

This paper presents a systematic review the literature pertaining to the development and use of population-based health indexes with regard to reason for development of the index, geographical level of aggregation, inclusion of health indicators, weighting, sources of data and validation. Any type of population-based health index that incorporated at least two health indicators was considered for inclusion in the review. Studies from the UK, Europe and North America were considered. Seventeen individual studies and one review describing a population-based health index are described. The health indexes were designed for a wide variety of purposes. Levels of geographical aggregation ranged from ward to national level. There was considerable variation between these studies regarding the indicators chosen for inclusion in the health indexes as well as the methods used to combine them. Fourteen of the 18 included studies reported information on weighting of the indicators. None of the studies gave justification for the method of weighting chosen. Indicators were on the whole obtained from routine data sources. Only four of the indexes addressed the problem of validity. A population-based health index is potentially a very useful tool for monitoring the health of a community. More research is needed to determine which health indicators should be used in the formation of such an index and the most appropriate method to combine them.

Adolescent↗
PubMed2005

Simulation analysis of the performance of a novel high sensitive spectral index for quantifying M-wave changes during fatigue.

A high sensitive fatigue index is desired to improve stimulation strategy and to prevent muscle damage in functional electrical simulations. The great number of indexes used shows that there is no index that satisfies all investigators. A way to develop a high sensitive index for quantifying M-wave changes during fatigue and to estimate its performance was analyzed. The changes in M-wave and its frequency distribution due to variations of intracellular action potential (IAP) and muscle fibre propagation velocity (MFPV) with fatigue were simulated. It was found that the ratio between the spectral moments of order -1 and 2 was considerably more sensitive to peripheral muscle fatigue than the mean (the ratio between the spectral moments of order 1 and 0) and median frequency traditionally used. The sensitivity of the new index depended on the electrode arrangement and position in respect to the active fibres. The belly-tendon detection promised the highest index sensitivity. The length of the active fibres also affected the index sensitivity. The shorter the fibres the lower was the index sensitivity. The sensitivity of the new index could be relatively high even in the case of traditionally used high-pass cut-off frequencies that could distort the M-wave shape.

Action Potentials↗
PubMed2005

Tissue oxygenation index is a useful monitor of histologic and neurologic outcome after cardiopulmonary bypass in piglets.

OBJECTIVE: Tissue oxygenation index is a novel monitoring indicator derived by near-infrared spectroscopy. We hypothesized that tissue oxygenation index could predict a minimum safe flow rate for specific bypass conditions. METHODS: Thirty-six piglets (age, 43 +/- 5 days; weight, 9.0 +/- 1.1 kg) underwent cardiopulmonary bypass with cerebral near-infrared spectroscopy (NIRO-300; Hamamatsu Photonics K.K., Hamamatsu City, Japan). Animals were cooled for 40 minutes to 15 degrees C, 25 degrees C, or 34 degrees C (pH-stat, hematocrit value of 20% or 30%, and pump flow of 100 mL . kg -1 . min -1), followed by low-flow perfusion (10, 25, or 50 mL . kg -1 . min -1) for 2 hours. Neurologic and behavioral evaluations were determined for 4 days. The brain was then fixed for histologic assessment. Tissue oxygenation index was defined as the average signal during low-flow bypass. RESULTS: Animals with an average tissue oxygenation index of less than 55% showed cerebral injury, whereas animals with an index of greater than 55% showed minimal or no evidence of injury. Correlations were found between average tissue oxygenation index and histologic score (Spearman rho = -0.65, P < .001) and neurologic deficit score (Pearson r = -0.50, P = .002) on the first postoperative day. Temperature (P < .001), flow rate (P < .001), and hematocrit value (P = .002) were multivariable predictors of tissue oxygenation index, as determined by means of multivariable analysis of variance. CONCLUSION: Tissue oxygenation index is a useful monitor for defining the minimum safe flow rate during cardiopulmonary bypass. An index value of less than 55% is a strong predictor of neurologic injury.

Animals↗
PubMed2007

Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan.

OBJECTIVES: To formulate an index representing area deprivation and elucidate the relation between the index and mortality in Japan. STUDY DESIGN: Ecological study for prefectures (N=47) and municipalities (N=3366) across Japan. METHODS: Based on socioeconomic indicators of seven domains of deprivation (i.e. unemployment, overcrowding, low social class and poverty, low education, no home ownership, low income and vulnerable group), an index was formulated using the z-scoring method. The relation between the index and mortality was examined by correlation analysis, hierarchical Poisson regression and comparison of standardized mortality ratio according to the index. RESULTS: The deprivation index ranged from -7.48 to 10.98 for prefectures and from -16.97 to 13.82 for municipalities. The index was significantly positively correlated with prefectural mortality, especially in the population aged under 74 years: r=0.65 for men and r=0.41 for women. At the municipal level, hierarchical Poisson regression showed a significant positive coefficient of the index to mortality for both men and women, and excess mortality in the most deprived fifth compared to the least deprived fifth was 26.4% in men and 11.8% in women. CONCLUSIONS: We formulated a deprivation index, which was substantially related to mortality at the prefectural and municipal levels. This study highlights the higher risk of dying among populations in socially disadvantaged areas and encourages the use of indices representing area socioeconomic conditions for further studies of area effects on health.

Adult↗
PubMed1996

Serial amniotic fluid index in severe preeclampsia: a poor predictor of adverse outcome.

OBJECTIVE: The purpose of the study was to determine the relationship between low amniotic fluid index and intrauterine growth restriction and nonreassuring fetal testing in patients with severe preeclampsia. STUDY DESIGN: We reviewed the medical records of 136 women with severe preeclampsia managed conservatively for at least 48 hours. Patients were followed up with a daily nonstress test and amniotic fluid index. We evaluated amniotic fluid index < or = 5 cm and < or = 7 cm, measured on admission or just before delivery (i.e., final), and attempted to correlate these findings with the incidence of nonreassuring fetal testing necessitating cesarean section or the incidence of intrauterine growth restriction (birth weight < or = 10th percentile). RESULTS: One hundred seven patients had a cesarean section, but only 42 (39%) of these were for a nonreassuring fetal heart rate tracing or a persistent biophysical profile of < or = 4, and 38 (36%) of the pregnancies resulted in infants with intrauterine growth restriction. During expectant management, the amniotic fluid index worsened for 61 (45%) patients and improved or remained the same for 75 (55%). For those with an amniotic fluid index of < or = 5 cm both on admission and at delivery, there was a significantly higher incidence of intrauterine growth restriction compared with those with an amniotic fluid index > 5 cm (p = 0.007 and p = 0.029, respectively). However, there was no association between intrauterine growth restriction and an amniotic fluid index < or = 7 cm. Moreover, there was no difference in the frequency of nonreassuring fetal heart rate testing on the basis of amniotic fluid volume (p = 0.59) or intrauterine growth restriction (p = 0.4). CONCLUSIONS: For women with severe preeclampsia remote from term, an amniotic fluid index < or = 5 cm is predictive of intrauterine growth restriction but lacks sensitivity. There is no association between the amniotic fluid index status and frequency of cesarean section for fetal distress or nonreassuring fetal testing.

Adult↗
PubMed1987

Characterization of mineral population by index particle: implication for the Stanton hypothesis.

Fibers from seven crocidolite samples used by M. F. Stanton et al. (J. Natl. Cancer Inst. 67, 965-975 (1981] were measured from STEM and optical images. Their masses were computed. From these data, the population was normalized to a sample mass of 1 micrograms, and the number of fibers in various size categories of a 1-microgram sample was compared to the tumor probability for each sample. The purposes of this study were (1) to evaluate errors in and the utility of population characterization by index number (log of the number of particles longer than 8 micron with widths equal to or less than 0.25 micron) and (2) to review the Stanton hypothesis in view of this analysis. The study found that in most cases the index number is a reliable population parameter. However, index numbers between 0 and 2.5 cannot be obtained. Therefore, populations of mineral fibers will fall into two groups: those without index particles, which have indeterminant index numbers, and those with index numbers between 2.5 and 6.0. Within Stanton's populations that contain index particles, where y equals logit tumor probability and x equals index number, r equals 0.307 (insignificant). Where y equals tumor probability and x equals index number, r equals 0.503 (significant). The correlation coefficients are low enough to suggest the possibility that factors other than size and shape play a role in mineral fiber carcinogenicity.

Asbestos↗
PubMed1990

A comparison of penile brachial index and angiography: evaluation of corpora cavernosa arterial inflow.

We studied 32 impotent patients with angiography. The penile branchial index was calculated from the maximal penile arterial pressure measured from any penile artery. In 15 of the 32 patients an attempt was made to isolate the cavernous artery pressure (cavernous artery penile brachial index). There was a poor correlation between angiography and penile branchial index (r equals 0.314) and between angiography and cavernous penile brachial index (r equals 0.637). We also evaluated 15 normal individuals and a wide range of penile brachial index values was found (0.7 to 1.0). Penile brachial index values from normal patients overlapped with those from impotent patients. Penile brachial index values from impotent patients with normal and abnormal arteries (as determined by angiography) overlapped. The fact that penile brachial index measurements are performed in the flaccid state and without direct visualization of the cavernous arteries accounts for some of the variability of the penile brachial index test.

Adult↗
PubMed2003

The preterm labor index and fetal fibronectin for prediction of preterm delivery with intact membranes.

OBJECTIVE: To compare the preterm labor index with the biochemical marker fetal fibronectin in predicting preterm delivery. METHODS: In 185 women with preterm labor and intact membranes, the preterm labor index was determined based on clinical findings of uterine contractions, bleeding, and cervical dilatation. An immunosorbent assay was used to measure oncofetal fibronectin. RESULTS: A significant negative correlation was noted between the preterm labor index and the interval from hospitalization to delivery. Based on a receiver operating characteristic curve, a preterm labor index 4 or higher was defined as positive. Rates of preterm delivery overall and of delivery within 1 week in the preterm labor index-negative group were 55.2% and 13.8%, respectively. Those in the preterm labor index-positive group were significantly higher (88.4% and 56.5%). With respect to predicting when a delivery would occur during the first week of hospitalization, the preterm labor index and fetal fibronectin did not differ in sensitivity (77.7% and 73.8%, respectively), specificity (79.5% and 74.2%), positive predictive value (66.7% and 60.8%), or negative predictive value (84.5% and 83.9%). However, within the preterm labor index-negative group, the rates of preterm delivery (68.4%), delivery within 1 week (28.9%), and neonatal treatment in an intensive care unit (36.8%) were significantly higher in fetal fibronectin-positive than in fibronectin-negative cases (46.2%, 9.0%, and 10.3%, respectively). CONCLUSION: The preterm labor index was similar to the fetal fibronectin assay in its ability to predict preterm delivery.

Adult↗
PubMed1993

[The Relative Complexity Index beta: value of each parameter].

The French health policy PMSI project (Program for a Medical Information System) is mainly aimed at development of cost analysis based on diagnosis related groups. An indicator of the relative costs of anaesthetics, the relative complexity index (ICR beta), was defined as the result of a computation of different indexes of surgical and anaesthetic procedures such as duration, patients ASA status, degree of emergency, stay in the recovery room. The aims of this study were 1) to analyze relative part of each index in ICR beta value and in ICR beta variance and 2) to assess the value of ICR beta as a cost or a complexity index. The study included 14,435 anaesthetics analyzed with the Dunn and Clarks multiple linear regression. Mean ICR beta was 267.28. The duration of the procedure accounted for 46% of the ICR beta value and surgery for 25%. The anaesthesia and the recovery accounted for 15% of the ICR beta value, but only for 0.0341 and 0.0347 respectively of the ICR beta variance. The product of the surgical procedure index by the ASA status index accounted for 0.259 of the ICR beta variance and the duration index for 0.650. The comparison of homogeneous groups with regard to the surgical procedure shows that intravenous anaesthesia accounts for 12.4% of the ICR beta value, inhalational anaesthesia for 13.84%, but exceeds 15% for regional anaesthesia (44.5% for caudal anaesthesia). For appendectomies (n = 114) duration index is still an important parameter in ICR beta variance (delta R2 = 0.354) but equivalent to the emergency index (delta R2 = 0.363).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗