需要重复重症监护室检查的患者的特征和结果
Matthew T Freedman1, Kathryn H Libby2, Kristin B Miller2
1Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA.
Mayo Clinic proceedings. Innovations, quality & outcomes
|September 11, 2023
概括
患者最初被拒绝进入重症监护室 (ICU),但后来在重新咨询时被录取,死亡率没有显著差异. 了解ICU复诊结果对于改善重症监护分拣实践至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 医院管理局 医院管理局
- 患者的治疗结果.
背景情况:
- 重症监护室 (ICU) 的入院决定对患者的治疗结果至关重要.
- 了解最初被拒绝进入ICU但后来被录取的患者的特征和结果对于优化资源配置和患者护理至关重要.
研究的目的:
- 调查最初被拒绝进入ICU的患者的死亡率和显著特征,这些患者随后在重新咨询后被录取.
- 为了比较在初次咨询后入院的患者与在重复咨询后入院的患者之间的结果.
主要方法:
- 进行了一项回顾性队列研究,涉及接受ICU咨询的成年住院患者 (n=3725).
- 患者被分为三个组:最初被拒绝进入ICU,后来被录取 (C2A1),第一次咨询后被录取 (C1A1),第一次咨询时被拒绝并从未被录取 (C1A0).
- 统计分析比较了这些群体之间的死亡率和子组特征.
主要成果:
- 最初被ICU拒绝的10%的患者后来在重新咨询时被录取.
- 在第一次咨询 (C1A1) 后入院的患者和在重复咨询 (C2A1) 后入院的患者之间,在调整后的医院死亡概率比率中没有发现显著差异.
- 亚组分析显示,根据患者代码状态 (完整代码与不尝试复苏) 和初始咨询设置 (急诊室与住院患者) 的基础上,再诊断入院率存在显著差异.
结论:
- 在重复咨询后入院的ICU患者的死亡率与初次咨询后入院的患者相似.
- 进一步研究ICU重新诊断的影响是必要的,以完善重症监护分拣策略,并确保公平的患者进入重症监护.
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