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危急病患者在医院获得的并发症
Graeme J Duke1,2,3, Frank Shann3,4, Cameron I Knott3,5,6
1Intensive Care Service, Eastern Health, Melbourne, VIC, Australia.
概括
医院获得的并发症 (HAC) 在重症患者中很常见,特别是在选择性手术中. 患者入院的特点,而不是医院的位置,强烈影响HAC率,表明复杂性而不是错误.
科学领域:
- 临界护理医学 临界护理医学
- 医疗保健服务研究 医疗服务研究
- 患者安全 患者安全
背景情况:
- 住院并发症 (HAC) 用于识别临床干预的医疗错误.
- 国家HAC系统旨在改善患者安全和结果.
- 了解HAC率对于改善医疗保健质量至关重要.
研究的目的:
- 量化大型医院多天住院的成年患者中HAC的发病率.
- 为了比较重症监护单位 (ICU) 和普通病房之间的HAC率.
- 评估HAC与临床恶化或医院现场之间的关联.
主要方法:
- 一个5年的行政数据集 (2014年7月 - 2019年6月) 的回顾性分析.
- 包括所有成年患者 (≥18岁) 来自维多利亚州47家医院的ICU.
- 根据入院类型 (计划/非计划),护理环境 (ICU/病房) 和医院同龄人群的分层.
主要成果:
- 超过211,000次ICU分离显示,42.6%至少有一次HAC事件.
- 常见的HAC包括妄想,感染,心律失常和呼吸衰竭.
- 在选择性手术患者和三级医院中观察到更高的HAC率,与患者入院特征密切相关.
结论:
- 危急病患者经历HAC事件的高负担.
- HAC率主要与患者入院特征有关,表明入院复杂性.
- HAC可以作为入院复杂性的指标,而不仅仅是医院获得的错误.
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