紧急程度与入院,死亡率和资源利用在三个急诊室分拣系统中的关联:一项多中心观察性研究
Marit E van Wegen1, Laura F C Fransen2, Wendy A M H Thijssen3
1Department of Emergency Medicine, Rijnstate Hospital, Arnhem, The Netherlands. Marit@vanwegen.nl.
概括
紧急严重性指数 (ESI) 可能比曼彻斯特选系统 (MTS) 和荷兰选标准 (NTS) 更有效,用于准确识别紧急病例并减少紧急部门的选不足.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 患者选系统 患者选系统
背景情况:
- 有效的患者分组对于优先考虑护理和管理急诊室 (ED) 的资源至关重要.
- 一个理想的分类系统应该尽量减少资源使用,住院和低急症患者的死亡率.
- 选系统必须显示出增加的住院和死亡风险,并具有更高的紧急级别,以确保对危急患者的及时护理.
研究的目的:
- 为了比较曼彻斯特选系统 (MTS),紧急严重性指数 (ESI) 和荷兰选标准 (NTS) 的性能.
- 研究ED患者紧急程度与资源利用,住院和住院死亡率之间的关联.
主要方法:
- 一项观察性多中心队列研究分析了来自七个荷兰ED的数据.
- 包括MTS,ESI和NTS的696,518个ED访问.
- 多变量后勤回归评估了紧急程度和结果之间的关联,根据患者人口统计学和医院类型进行调整.
主要成果:
- 与MTS和NTS相比,ESI在最低紧急级别的资源利用率和住院率明显较低.
- 在最低紧急级别的死亡率显著低于ESI (0.8%),而不是MTS (6.3%) 和NTS (12.4%).
- 欧洲社会调查显示,随着紧急程度的上升,住院和死亡风险的增加更为明显.
结论:
- 紧急严重程度指数 (ESI) 在区分患者紧急程度方面似乎更有效.
- 与曼彻斯特分拣系统 (MTS) 和荷兰分拣标准 (NTS) 相比,ESI可以降低分拣不足的风险.
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