使用快速反应系统触发集群来描述住院成年患者临床恶化的模式
Rebecca J Piasecki1, Elizabeth A Hunt1, Nancy Perrin1
1Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, United States.
Resuscitation
|November 12, 2023
概括
确定了六个快速响应系统 (RRS) 触发集群,揭示了RRS事件的独特模式. 这些集群与住院患者心脏骤停和死亡风险的增加有关.
科学领域:
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
背景情况:
- 快速响应系统 (RRS) 事件通常涉及多个触发器,但触发器同时发生的模式尚不清楚.
- 识别这些模式对于理解RRS事件激活和患者结果至关重要.
研究的目的:
- 识别激活RRS事件的多个触发器的模式或集群.
- 确定这些RRS触发集群与住院成年患者患者结果的关联.
主要方法:
- 在2015年1月至2019年12月使用Get With The Guidelines-Resuscitation注册表分析了134,406起RRS事件.
- 集群分析的应用,以确定RRS触发集群.
- 统计方法包括皮尔森的千平方,ANOVA和多层逻辑回归来检查患者的特征和结果.
主要成果:
- 确定了六个不同的RRS触发器集群,其特点是特定的触发器组合,如短呼吸,呼吸困难,氧气和度降低,呼吸抑郁,精神状态变化,短心率和低血压.
- 在确定的集群中观察到患者特征的显著差异.
- 患有呼吸系统抑郁/精神状态变化和低血压/工作人员担忧的集群患者,患有住院心脏骤停和死亡的可能性增加.
结论:
- 发现了6种新的RRS触发器集群,证明了与患者不良结果的多种关联.
- 了解这些RRS触发集群可以提高对RRS事件的清晰度,并支持临床决策.
- 这些发现可能会改进对RRS事件的解释及其与患者结果的联系.
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