重症监护病房再入院的决定因素:一个前性观察性研究
Ratnesh Kumar1, Brijesh P Singh1, Zia Arshad1
1Anesthesiology and Critical Care, King George's Medical University, Lucknow, IND.
Cureus
|July 22, 2024
概括
在重症监护室 (ICU) 住院后重新入院是常见的,特别是在患有高血压和糖尿病等并发症的老年男性中. 呼吸系统和神经系统问题是主要原因,导致重新入院患者的高死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 患者的治疗结果.
- 医疗卫生流行病学 医疗卫生流行病学
背景情况:
- 重症监护室 (ICU) 幸存者的再接收受复杂因素的影响,包括社会经济地位,医疗保健准入,疾病严重程度,并发症和支持系统.
- 在ICU停留期间出现的并发症,如感染和器官功能障碍,进一步提高了再接收风险.
- 了解这些决定因素对于制定减少再入院和改善ICU幸存者的护理的干预措施至关重要.
研究的目的:
- 为了确定与ICU幸存者重新入院相关的因素.
- 确定该患者群体中再入院的主要原因.
主要方法:
- 一项前性观察性研究在一年内在第三级ICU中进行.
- 108名ICU幸存者被纳入,收集了有关人口统计,并发病,初级诊断,先前治疗 (血管压缩剂,镇静剂),再入院原因,先前ICU停留时间和结果的数据.
- 进行了统计分析,以确定再接收的风险因素和原因.
主要成果:
- 再入院率为10.4%,50-70岁的年龄组和男性受影响最大.
- 常见的并发病包括高血压 (18.52%) 和糖尿病 (11.11%). 腹部受伤是常见的初级诊断.
- 呼吸系统 (30.56%) 和神经系统 (25%) 的并发症是重新入院的主要原因,与59.26%的高死亡率相关.
结论:
- 在这个三级ICU中再入院的发生率为10.4%,呼吸道和神经系统问题是主要的驱动因素.
- 重新入住ICU的重大风险因素包括晚年,男性性别,长时间入住ICU,特定的并发症 (高血压,糖尿病),腹部受伤,以及先前使用镇静和机械通风.
- 再入院的患者面临相当高的死亡风险,这凸显了针对性治疗后ICU护理策略的必要性.
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