患者入院来源对呼吸器重症监护室结果的影响
Büşra Durak1, Gökay Güngör2, Sinem Güngör2
1Department of Pulmonary Disease, Çorum Hitit University Faculty of Medicine, Corum, Türkiye. drbusradurak@gmail.com.
BMC pulmonary medicine
|March 19, 2025
概括
从医院病房进入重症监护室 (ICU) 的重症患者的死亡率高于从急诊室 (ED) 入院的患者. 改善ED分拣可能会改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 关于重症监护室 (ICU) 入院来源与患者死亡率之间的关联,研究有限.
- 了解入院来源 (急诊室与病房) 的影响对于优化重症监护服务至关重要.
研究的目的:
- 调查ICU入院来源 (急诊室与病房) 与重症患者的死亡率之间的相关性.
- 根据患者进入ICU的入口点来确定影响结果的因素.
主要方法:
- 对2018年1月至2019年12月期间因急性呼吸衰竭入院的2,173名ICU患者进行了回顾性观察性横截面研究.
- 收集的数据包括人口统计,并发病,诊断,APACHE II分数,入院来源,机械通风使用,停留时间和死亡率.
- 从急诊室 (ED) 入院的患者和从病房入院的患者之间进行了统计比较.
主要成果:
- 从病房入院的患者 (54%) 与从ED入院的患者 (46%) 相比,在ICU停留时间更长 (3天而不是2天),ICU死亡率更高 (OR: 1.66,P < 0.001).
- 病房入院与侵入性机械通风率较高 (25%与17%相比),而ED入院患者使用非侵入性机械通风率较高 (50%与35%相比).
- 肺炎,恶性瘤,间歇性肺病和非侵入性通风衰竭与增加的死亡率有关.
结论:
- 从病房到ICU的转移与死亡率明显高于急诊部到ICU的入院率有关.
- 在急诊室加强分拣方案,可以通过确保及时和适当的重症监护来改善患者的治疗结果.
- 对优化患者流动和基于入院来源的资源配置进行进一步的研究是有必要的.
相关概念视频
01:19Respiratory Assessment: Purpose and Indications
1.0K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.0K
01:29Acute Respiratory Failure-V
113
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
113
01:20Assessment of Ventilation I: Respiratory Rate
978
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
978
01:23Acute Respiratory Failure-IV
115
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
115
01:23Assessment of Respiration
1.0K
The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.0K
01:30Pneumonia I: Introduction
201
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
201