医疗器械在重症监护室的自我移除:一项回顾性研究
John Culhane1, Raymond Okeke2, Kellie Bushe2
1Trauma, SSM Health St. Louis University Hospital, St. Louis, USA.
Cureus
|July 28, 2025
概括
在ICU中,医疗器械自拆 (SRMD) 是常见的,并且与较高的死亡率有关. 妄想,酒精和药物滥用是关键的危险因素,这表明妄想管理对于预防至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 患者安全 患者安全
- 医疗器械管理 医疗器械管理
背景情况:
- 医疗器械自拆 (SRMD) 是重症监护室 (ICU) 中经常发生的一种情况.
- 现有的研究主要侧重于自我排泄,对其他必要的医疗设备的去除不太重视.
- 了解SRMD的范围和预测因素对于改善重症监护机构患者的治疗结果至关重要.
研究的目的:
- 在ICU中调查SRMD的频率和特征.
- 为了确定与SRMD相关的预测因素.
- 确定SRMD对患者死亡率的影响.
主要方法:
- 对MIMIC III数据库的回顾性图表审查.
- 对自由文本临床笔记的分析,以确定SRMD的实例.
- 统计分析包括单变量 (基平方,t测试) 和多变量 (逻辑回归) 方法来评估预测因素和死亡结果.
主要成果:
- 5.3%的ICU患者参与了SRMD,鼻胃管是最常被移除的设备.
- 进行SRMD的患者的死亡率明显较高 (56%对40%,p<0.001).
- 妄病史 (OR 3.15),酒精戒断 (OR 2.0) 和药物滥用 (OR 1.7) 是SRMD的独立风险因素.
结论:
- 在ICU中,SRMD是一个重要的问题,与死亡率的增加有关.
- 妄想是SRMD的主要驱动因素,而药物滥用是导致因素.
- 准妄症管理是预防SRMD和提高ICU患者安全的关键策略.
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