Cardiac Surgery Intensive Care Unit, Evangelismos General Hospital of Athens, 5-47 Ipsilantou Street, Athens, Greece.
Eur J Cardiovasc Nurs. 2012 Mar;11(1):23-33. doi: 10.1016/j.ejcnurse.2010.09.005.
Mortality is an important healthcare index for assessing the quality and the effectiveness of the provided nursing care.
The aim of this study was to identify the risk factors for increased in-hospital mortality among cardiac surgery patients.
We followed up prospectively 313 consecutive patients who were admitted to the cardiac surgery intensive care unit (ICU) of a general, tertiary hospital in Athens during a 1 year period. Data collection was performed by using a short questionnaire and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE for assessing the nursing workload (NWL) and the perioperative risk for each patient respectively.
Patients with a high 1st day NAS had an almost 3.3 times greater probability of death during their hospitalization (OR 3.3, 95%CI 1.4-8). Moreover, patients with increased perioperative risk (OR 4.2, 95%CI 1.50-12) and ICU length of stay (ICU-LOS) (OR 16.8, 95%CI 4.8-58.6) had statistically significant higher in-hospital mortality.
Increased level of NWL, patient perioperative risk and ICU-LOS are closely associated with increased in-hospital mortality of cardiac surgery patients. The correlation between NWL and mortality represents the strong link of the nursing profession with the improvement of the effectiveness and quality of care.
死亡率是评估护理质量和效果的重要医疗保健指标。
本研究旨在确定心脏外科患者住院死亡率增加的危险因素。
我们前瞻性随访了 313 例连续患者，这些患者在一年期间入住雅典一家综合三级医院的心脏外科重症监护病房（ICU）。通过使用简短的问卷和两个工具（护理活动评分（NAS）和逻辑 EuroSCORE）来收集数据，分别评估护理工作量（NWL）和每位患者的围手术期风险。
第 1 天 NAS 较高的患者在住院期间死亡的可能性几乎增加了 3.3 倍（OR 3.3，95%CI 1.4-8）。此外，围手术期风险增加（OR 4.2，95%CI 1.50-12）和 ICU 住院时间（ICU-LOS）（OR 16.8，95%CI 4.8-58.6）的患者住院死亡率也有统计学意义。
NWL 水平升高、患者围手术期风险和 ICU-LOS 与心脏外科患者住院死亡率增加密切相关。NWL 与死亡率之间的相关性表明护理专业与提高护理效果和质量之间存在着紧密联系。
