Tafelski S, Nachtigall I, Deja M, Tamarkin A, Trefzer T, Halle E, Wernecke K D, Spies C
Department of Anaesthesiology and Intensive Care, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
J Int Med Res. 2010 Sep-Oct;38(5):1605-16. doi: 10.1177/147323001003800505.
Computer-assisted decision support systems (CDSS) are designed to improve infection management. The aim of this prospective, clinical pre- and post-intervention study was to investigate the influence of CDSS on infection management of severe sepsis and septic shock in intensive care units (ICUs). Data were collected for a total of 180 days during two study periods in 2006 and 2007. Of the 186 patients with severe sepsis or septic shock, 62 were stratified into a low adherence to infection management standards group (LAG) and 124 were stratified into a high adherence group (HAG). ICU mortality was significantly increased in LAG versus HAG patients (Kaplan-Meier analysis). Following CDSS implementation, adherence to standards increased significantly by 35%, paralleled with improved diagnostics, more antibiotic-free days and a shortened time until antibiotics were administered. In conclusion, adherence to infection standards is beneficial for patients with severe sepsis or septic shock and CDSS is a useful tool to aid adherence.
计算机辅助决策支持系统（CDSS）旨在改善感染管理。这项前瞻性临床干预前后研究的目的是调查CDSS对重症监护病房（ICU）中严重脓毒症和感染性休克感染管理的影响。在2006年和2007年的两个研究期间共收集了180天的数据。在186例严重脓毒症或感染性休克患者中，62例被分层到感染管理标准低依从性组（LAG），124例被分层到高依从性组（HAG）。LAG组患者的ICU死亡率显著高于HAG组患者（Kaplan-Meier分析）。实施CDSS后，标准依从性显著提高了35%，同时诊断得到改善，无抗生素使用天数增加，抗生素给药时间缩短。总之，遵守感染标准对严重脓毒症或感染性休克患者有益，CDSS是帮助遵守标准的有用工具。
