A new classification for emergency critically ill patients and analysis of their adverse events during intrahospital transport: A cluster analysis.

IF 3 3区 医学 Q1 NURSING
Nursing in Critical Care Pub Date : 2025-03-01 Epub Date: 2024-07-02 DOI:10.1111/nicc.13099
Ying An, Kai Cao, Fei Li, Qi Lu, Ya-Mei Guan, Zhen-Hui Lu, Ai-Ping Wang, Zi-Rong Tian
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Abstract

Background: Critical patients may experience various adverse events during transportation within hospitals. Therefore, quickly evaluating and classifying patients before transporting them from the emergency department and focusing on managing high-risk patients are critical. At present, no unified classification method exists; all the current approaches are subjective.

Aim: To ensure transportation safety, we conducted a cluster analysis of critically ill patients transferred from the emergency department to the intensive care unit.

Study design: Single-centre cohort study. This study was conducted at a comprehensive first-class teaching hospital in Beijing. Convenience sampling and continuous enrolment were employed. We collected data from 1 January 2019, to 31 December 2021. All patients were transferred from the emergency department to the intensive care unit, and cluster analysis was conducted using five variables.

Results: A total of 584 patients were grouped into three clusters. Cluster 1 (high systolic blood pressure group) included 208 (35.6%) patients. Cluster 2 (high heart rate and low blood oxygen group) included 55 (9.4%) patients. Cluster 3 (normal group) included the remaining 321 (55%) patients. The oxygen saturation levels of all the patients were lower after transport, and the proportion of adverse events (61.8%) was the highest in Cluster 2 (p < .05).

Conclusions: This study utilized data on five important vital signs from a cluster analysis to explore possible patient classifications and provide a reference for ensuring transportation safety.

Relevance to clinical practice: Before transferring patients, we should classify them and implement targeted care. Changes in blood oxygen levels in all patients should be considered, with a focus on the occurrence of adverse events during transportation among patients with high heart rates and low blood oxygen levels.

急诊重症患者的新分类及其院内转运期间的不良事件分析:聚类分析。
背景:危重病人在医院内转运过程中可能会发生各种不良事件。因此,在从急诊科转运病人之前对其进行快速评估和分类,并重点管理高危病人至关重要。目的:为确保转运安全,我们对从急诊科转入重症监护室的危重病人进行了分组分析:研究设计:单中心队列研究。本研究在北京一家综合性一流教学医院进行。研究采用了方便抽样和连续登记的方法。我们收集了从 2019 年 1 月 1 日至 2021 年 12 月 31 日的数据。所有患者均从急诊科转入重症监护室,并使用五个变量进行聚类分析:共有 584 名患者被分为三个群组。第一组(收缩压高组)包括 208 名患者(35.6%)。第 2 组(高心率和低血氧组)包括 55 名患者(9.4%)。第 3 组(正常组)包括其余 321 名患者(55%)。所有患者在转运后的血氧饱和度水平都较低,而不良事件的比例(61.8%)在第 2 组中最高(P 结 论):本研究利用聚类分析得出的五项重要生命体征数据,探讨了可能的患者分类方法,为确保转运安全提供了参考:在转运病人之前,我们应该对他们进行分类,并实施有针对性的护理。应考虑所有患者的血氧含量变化,重点关注心率高、血氧含量低的患者在转运过程中发生的不良事件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.00
自引率
13.30%
发文量
109
审稿时长
>12 weeks
期刊介绍: Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics. Papers published in the journal normally fall into one of the following categories: -research reports -literature reviews -developments in practice, education or management -reflections on practice
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