在瑞士成人ICU的诊断模式和资源利用的变化在COVID-19的前两个浪潮期间:一项探索性研究
Marco Previsdomini1, Andreas Perren1,2,3, Alessandro Chiesa1
1Intensive Care Unit, Department of Intensive Care Medicine - Ente Ospedaliero Cantonale, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland.
Swiss medical weekly
|April 5, 2024
概括
由于COVID-19大流行,瑞士重症监护室 (ICU) 的入院人数减少了,但患者的严重程度,入院时间和死亡率增加了. 这一转变凸显了大流行对重症监护资源和患者结果的深刻影响.
科学领域:
- 关键护理医学 关键护理医学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 2019年新冠肺炎 (COVID-19) 疫情对全球的医疗保健系统产生了重大影响,特别是重症监护病房 (ICU).
- 了解疫情期间ICU患者人口统计和资源利用情况的变化,对于有效的医疗保健规划至关重要.
研究的目的:
- 分析在前两波COVID-19期间瑞士ICU患者分布和特征的变化.
- 将这些变化与大流行前两年 (2018-2019) 的数据进行比较.
主要方法:
- 使用瑞士国家ICU注册表进行的探索性研究.
- 分析了来自84个认证的瑞士ICU的242,935名患者记录.
- 2020年ICU入院,患者特征,入院时间 (LOS),死亡率,护理工作量和医院资源的比较,与2018/2019年平均水平相比.
主要成果:
- 与2018/2019年相比,2020年整体ICU入院人数下降了9.6%,男性患者的比例更高.
- 计划入院的人数显著下降,而因呼吸系统诊断和急性呼吸系统应急综合征 (ARDS) 需要隔离的非计划入院人数增加了一倍多.
- 集中治疗室停留时间 (LOS) 增加了20.8%,导致总住院日数大幅增加. 在2020年,护理工作量 (NEMS) 和ICU死亡率也大幅增加.
结论:
- 由于COVID-19大流行,瑞士ICU发生了深刻的变化,其特点是整体入院减少,但增加了患者的严重程度和关键护理需求.
- 计划住院病例的显著下降表明对选择性手术产生了重大影响,而呼吸系统病例和ARDS急剧增加使资源紧张.
- 这些发现表明,ICU LOS,护理工作量和死亡率大幅增加,这凸显了大流行对重症监护服务和患者结果的重大影响.
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