The impact of neurocritical patient transfer on outcomes: retrospective analysis of practice in the largest neurosurgical centre in Lithuania.

IF 1.6 Q2 ANESTHESIOLOGY
Greta Kasputytė, Marija Jakiševaitė, Augustė Žurauskaitė, Aurika Karbonskienė, Milda Švagždienė, Birutė Kumpaitienė, Neringa Balčiūnienė, Tomas Tamošuitis
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Abstract

Introduction: Critical neurological conditions require urgent assessment and treatment. The quality of care and treatment provided during the transportation is important and related to the outcome of critically ill patients. We aimed to assess the quality of interhospital transportation of neurocritical patients in the largest neurosurgical cluster in Lithuania and identify possible outcome prediction variables.

Material and methods: A retrospective cohort study was conducted. We analysed the data from 106 neurocritical patients who were transported to the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Neurosurgery Clinic in 2018. We collected the needed data from patients' medical history, referrals, and transfer sheets. In our research, we evaluated the quality of referrals and the quality of filling protocols.

Results: The transportation protocols showed that during the transferrals diuresis, end-tidal carbon dioxide (ETCO2), pupil size, and reaction to light were not routinely measured in any of the patients, as opposed to other vital signs. We found that less than half of referrals (42%) were informative and suitable for sending the patient to another hospital. Results showed that the first systolic arterial blood pressure (sABP) measured at Neuro-ICU is associated with patient outcomes. Higher sABP was seen in the group of patients with negative outcomes (death, continued need for care).

Conclusions: This study demonstrated that monitoring of vital signs and neurological parameters as well as the quality of referrals were found to be the weakest links in the neurocritical patient transfer.

神经重症患者转院对疗效的影响:立陶宛最大神经外科中心实践的回顾性分析。
简介危重的神经系统疾病需要紧急评估和治疗。转运过程中提供的护理和治疗质量非常重要,关系到危重病人的预后。我们旨在评估立陶宛最大的神经外科集群中神经重症患者的院间转运质量,并确定可能的转运结果预测变量:我们进行了一项回顾性队列研究。我们分析了2018年被转运至立陶宛健康科学大学考纳斯诊所神经外科诊所医院的106名神经危重患者的数据。我们从患者的病史、转诊单和转院单中收集了所需的数据。在研究中,我们评估了转诊的质量和填充协议的质量:转运协议显示,在转运过程中,与其他生命体征相比,所有患者均未常规测量利尿、潮气末二氧化碳(ETCO2)、瞳孔大小和对光的反应。我们发现,不到一半的转诊病例(42%)具有参考价值,适合将患者送往其他医院。结果显示,神经重症监护室首次测量的收缩压与患者的预后有关。在出现不良后果(死亡、继续需要护理)的患者组中,收缩压较高:这项研究表明,生命体征和神经参数的监测以及转诊质量是神经重症患者转运过程中最薄弱的环节。
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
3.00
自引率
5.90%
发文量
48
审稿时长
25 weeks
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