Cline Scott D, Schertz Robyn A K, Feucht Eric C
Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI 49007, USA.
Am J Emerg Med. 2009 Sep;27(7):843-6. doi: 10.1016/j.ajem.2008.04.018.
To determine if expedited admission (<2 hours) of critically ill patients requiring intubation and mechanical ventilation from the emergency department (ED) to the intensive care unit (ICU) decreases ICU and hospital length of stay.
Patients with respiratory failure that required intubation and mechanical ventilation who were admitted to the hospital between June 2004 and May 2006 were retrospectively identified from the Project IMPACT database. Patients were divided into 2 groups based on ED length of stay: expedited (<2 hours) or nonexpedited (>2 hours).
The expedited (n = 12) and nonexpedited (n = 66) groups were comparable in demographics, medical conditions, and disease severity. Mean duration of mechanical ventilation was significantly shorter in the expedited group (28.4 hours vs 67.9 hours; P = .0431), as was mean ICU length of stay (2.4 days vs 4.9 days; P = .0209). Length of hospital stay tended to be shorter for the patients in the expedited group (6.8 days vs 8.9 days; P = .0609).
Expedited admission (<2 hours) of critically ill patients requiring intubation and mechanical ventilation from the ED to the ICU was associated with shorter durations of mechanical ventilation and ICU length of stay, suggesting that prompt ICU admission results in improved use of resources.
确定将急诊科(ED)中需要插管和机械通气的重症患者快速收治(<2小时)至重症监护病房(ICU)是否会缩短ICU住院时间和住院时间。
从IMPACT项目数据库中回顾性识别2004年6月至2006年5月期间入院的需要插管和机械通气的呼吸衰竭患者。根据在ED的住院时间将患者分为两组:快速组(<2小时)或非快速组(>2小时)。
快速组(n = 12)和非快速组(n = 66)在人口统计学、医疗状况和疾病严重程度方面具有可比性。快速组的机械通气平均持续时间显著更短(28.4小时对67.9小时;P = 0.0431),ICU平均住院时间也是如此(2.4天对4.9天;P = 0.0209)。快速组患者的住院时间倾向于更短(6.8天对8.9天;P = 0.0609)。
将急诊科中需要插管和机械通气的重症患者快速收治(<2小时)至ICU与机械通气持续时间和ICU住院时间缩短相关,这表明及时入住ICU可改善资源利用。