重症监护病房床位的可用性和术后结果:一项跨国队列研究
Ruaraidh A S Campbell1, Tharusan Thevathasan2, Danny J N Wong3,4
1National Insitute for Health Research University College London Hospitals Biomedical Research Centre, University College, London, UK.
Anaesthesia
|September 26, 2024
概括
术后重症监护入院的决定是不同的,取决于床位的可用性,而不是患者的风险. 先进的统计分析表明,基于入院的患者结局没有差异,这需要进一步的试验.
科学领域:
- 关键护理医学 关键护理医学
- 医疗服务研究 医疗服务研究
- 外科手术的结果
背景情况:
- 重症监护病床是一个有限的资源,术后入院的建议往往不被遵守.
- 关键护理的现实世界优先级决定及其对患者结果的影响仍然不清楚.
研究的目的:
- 调查影响术后重症监护入院决策的因素.
- 通过使用先进的统计方法,评估重症监护入院对术后发病率的影响.
主要方法:
- 2017年对248家英国和澳大利亚医院的19,491名成年外科患者进行了观察性队列研究.
- 逻辑回归和仪器变量分析使用重症监护病床占用率变化来估计因果关系.
- 主要结局:在第7天的术后发病率.
主要成果:
- 术后重症监护入院与手术风险和重症监护病床的可用性有关 (每张床的OR为1.04).
- 医院之间入院概率的显著差异 (中位数OR3.05).
- 没有证据表明术后发病率与重症监护入院的差异 (OR 0.91).
结论:
- 术后重症监护入院是可变的,并受床位的可用性影响.
- 对混的统计调整表明,重症监护入院造成的伤害估计减少了.
- 这些发现支持进行临床试验,以评估重症监护入院对精选患者的潜在益处.
更多相关视频
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
1.4K
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
2.7K
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
3
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
3
01:23Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4