感染患者与非感染患者急诊入院后计划外重症监护病房（ICU）转归的危险因素比较。
Comparison of risks factors for unplanned ICU transfer after ED admission in patients with infections and those without infections.
作者信息
Tsai Jeffrey Che-Hung, Cheng Ching-Wan, Weng Shao-Jen, Huang Chin-Yin, Yen David Hung-Tsang, Chen Hsiu-Ling
机构信息
Department of Emergency Medicine, China Medical University Hospital, No. 2 Yude Road, North District, Taichung City 404, Taiwan ; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan ; Department of Industrial Engineering & Enterprise Information, Tunghai University, Taichung 407, Taiwan.
Department of Emergency Medicine, Cheng-Ching General Hospital, Taichung 407, Taiwan.
出版信息
ScientificWorldJournal. 2014 Jan 2;2014:102929. doi: 10.1155/2014/102929. eCollection 2014.
BACKGROUND
The objectives of this study were to compare the risk factors for unplanned intensive care unit (ICU) transfer after emergency department (ED) admission in patients with infections and those without infections and to explore the feasibility of using risk stratification tools for sepsis to derive a prediction system for such unplanned transfer.
METHODS
The ICU transfer group included 313 patients, while the control group included 736 patients randomly selected from those who were not transferred to the ICU. Candidate variables were analyzed for association with unplanned ICU transfer in the 1049 study patients.
RESULTS
Twenty-four variables were associated with unplanned ICU transfer. Sixteen (66.7%) of these variables displayed association in patients with infections and those without infections. These common risk factors included specific comorbidities, physiological responses, organ dysfunctions, and other serious symptoms and signs. Several common risk factors were statistically independent.
CONCLUSIONS
The risk factors for unplanned ICU transfer in patients with infections were comparable to those in patients without infections. The risk factors for unplanned ICU transfer included variables from multiple dimensions that could be organized according to the PIRO (predisposition, insult/infection, physiological response, and organ dysfunction) model, providing the basis for the development of a predictive system.
背景
本研究的目的是比较感染患者和非感染患者在急诊科（ED）入院后转入重症监护病房（ICU）的风险因素，并探讨使用脓毒症风险分层工具来推导此类非计划转入预测系统的可行性。
方法
ICU转入组包括313例患者，而对照组包括从未转入ICU的患者中随机选取的736例患者。对1049例研究患者中的候选变量进行分析，以确定其与非计划ICU转入的相关性。
结果
24个变量与非计划ICU转入相关。其中16个（66.7%）变量在感染患者和非感染患者中均显示出相关性。这些常见风险因素包括特定的合并症、生理反应、器官功能障碍以及其他严重症状和体征。几个常见风险因素在统计学上是独立的。
结论
感染患者非计划ICU转入的风险因素与非感染患者相当。非计划ICU转入的风险因素包括来自多个维度的变量，这些变量可根据PIRO（易感性、损伤/感染、生理反应和器官功能障碍）模型进行组织，为开发预测系统提供了依据。
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