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三个斯堪的纳维亚国家重症监护病房未存活者住院时间的差异。

Variations in the length of stay of intensive care unit nonsurvivors in three Scandinavian countries.

机构信息

Health Services Research Centre, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway.

出版信息

Crit Care. 2010;14(5):R175. doi: 10.1186/cc9279. Epub 2010 Oct 4.

Abstract

INTRODUCTION

The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors.

METHODS

Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression).

RESULTS

Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II.

CONCLUSIONS

Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries.

摘要

简介

入住重症监护病房(ICU)但未存活患者的住院时间(LOS)通常未予报道,但却是资源利用的一个重要指标。ICU 未存活患者的 LOS 也可能是各单位间文化和组织差异的一个标志物。本研究基于芬兰、瑞典和挪威的全国重症监护登记处,旨在报告 ICU 病死率,并记录 ICU 未存活患者 LOS 所反映的资源利用情况。

方法

2006 年将来自 53305 例 ICU 患者的登记处数据合并入一个数据库。对 LOS 进行单变量和多变量分析(Cox 比例风险回归),并据此对 ICU 未存活患者进行亚组分析。

结果

有 52255 例患者的 ICU 出院时存活状态可查。总体 ICU 病死率为 9.1%。芬兰和瑞典 ICU 未存活患者的 LOS 中位数为 1.3 天,挪威为 1.9 天。80 岁以上、急症入院和病情最严重的患者的 LOS 最短。多变量分析证实,校正年龄组、入院类别、性别和医院类型后,挪威的 LOS 更长。LOS 与疾病严重度呈负相关,可通过 APACHE II 和 SAPS II 评分测量。

结论

尽管在文化、宗教和教育方面具有相似性,但芬兰、挪威和瑞典三国 ICU 未存活患者的 LOS 存在显著差异。总体而言,北欧国家的 ICU 病死率较低。

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