一级创伤中心重症监护室的再入院率。

IF 1.8 3区 医学 Q2 SURGERY
Benjamin Moore, Kacee J Daniels, Blake Martinez, Kevin W Sexton, Kyle J Kalkwarf, Matthew Roberts, Stephen M Bowman, Hanna K Jensen
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引用次数: 0

摘要

简介:重症监护病房(ICU)再入院与发病率和死亡率的增加、住院时间的延长以及医疗费用的增加有关。本研究旨在对重症监护室再入院的创伤患者进行大规模队列分析,确定风险因素的特征,并提供质量改进策略,以限制重症监护室再入院率:方法:研究人员对 2014 年至 2021 年在一家一级创伤中心重症监护室住院的成年创伤患者进行了回顾性队列分析。患者被分为再入院组和未再入院组。使用描述性统计和逻辑回归法将再次入院的患者与未再次入院的同类患者进行比较:本研究共纳入 3632 例患者,其中 278 例(7.7%)再次入住重症监护病房。在年龄、Elixhauser 合并症评分、使用呼吸机天数和需要呼吸机支持的患者人数方面发现了显著差异。此外,逻辑回归显示,年龄和埃利克豪斯综合症评分的增加与再次入住重症监护室的可能性增加有关。在研究期间,ICU 再入院率上升,而 ICU 病程缩短:结论:年龄、Elixhauser 疾病综合评分和呼吸机的使用都是 ICU 再入院的重要风险因素。在我们的研究期间,发现了一个令人担忧的趋势,即 ICU 再入院率增加,而 ICU 留院时间缩短。在发现这一趋势后,我院采取了一些缓解策略,成功扭转了重症监护室再入院率的趋势,使其低于全国平均水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intensive Care Unit Readmissions in a Level I Trauma Center.

Introduction: Intensive care unit (ICU) readmissions are associated with increased morbidity and mortality rates, longer hospitalization, and increased health-care expenditures. This study sought to present a large cohort of trauma patients readmitted to the ICU, characterizing risk factors and providing quality improvement strategies to limit ICU readmission.

Methods: A retrospective cohort analysis was conducted on adult trauma patients admitted to the ICU at a single level I trauma center from 2014 to 2021. Patients were split into readmission and no readmission groups. Patients experiencing readmission were compared to a similar group that was not readmitted using descriptive statistics and logistic regression.

Results: In this study, 3632 patients were included and 278 (7.7%) were readmitted to the ICU. Significant differences were found in age, Elixhauser Comorbidity score, number of days on a ventilator, and number of patients requiring ventilator support. Furthermore, logistic regression showed that increasing age and the Elixhauser Comorbidity Score were associated with an increased likelihood of ICU readmission. Over the study period, the ICU readmission rate increased while the ICU length decreased.

Conclusions: Age, Elixhauser Comorbidity score, and ventilator use were all significant risk factors for ICU readmission. During our study period, a concerning trend of increasing ICU readmissions and decreased ICU length of stay was found. By identifying this trend, our institution was able to employ mitigation strategies that have successfully reversed the trend in ICU readmissions, decreasing the rate below the national average.

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来源期刊
CiteScore
3.90
自引率
4.50%
发文量
627
审稿时长
138 days
期刊介绍: The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.
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