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实施重症监护信息系统可缩短重症监护病房的住院时间。

The implementation of an Intensive Care Information System allows shortening the ICU length of stay.

作者信息

Levesque Eric, Hoti Emir, Azoulay Daniel, Ichai Philippe, Samuel Didier, Saliba Faouzi

机构信息

Centre Hépato-Biliaire, Hôpital Paul Brousse, AP-HP, 12 Avenue Paul-Vaillant-Couturier, 94804, Villejuif, France,

出版信息

J Clin Monit Comput. 2015 Apr;29(2):263-9. doi: 10.1007/s10877-014-9592-4. Epub 2014 Jun 28.

Abstract

Intensive care information systems (ICIS) implemented in intensive care unit (ICU) were shown to improve patient safety, reduce medical errors and increase the time devolved by medical/nursing staff to patients care. Data on the real impact of ICIS on patient outcome are scarce. This study aimed to evaluate the effects of ICIS on the outcome of critically-ill patients. From January 2004 to August 2006, 1,397 patients admitted to our ICU were enrolled in this observational study. This period was divided in two phases: before the implementation of ICIS (BEFORE) and after implementation of ICIS (AFTER). We compared standard ICU patient's outcomes: mortality, length of stay in ICU, hospital stay, and the re-admission rate depending upon BEFORE and AFTER. Although patients admitted AFTER were more severely ill than those of BEFORE (SAPS II: 32.1±17.5 vs. 30.5±18.5, p=0.014, respectively), their ICU length of stay was significantly shorter (8.4±15.2 vs. 6.8±12.9 days; p=0.048) while the re-admission rate and mortality rate were similar (4.4 vs. 4.2%; p=0.86, and 9.6 vs 11.2% p=0.35, respectively) in patients admitted AFTER. We observed that the implementation of ICIS allowed shortening of ICU length of stay without altering other patient outcomes.

摘要

重症监护病房(ICU)中实施的重症监护信息系统(ICIS)已被证明可提高患者安全性、减少医疗差错并增加医护人员用于患者护理的时间。关于ICIS对患者结局实际影响的数据很少。本研究旨在评估ICIS对重症患者结局的影响。2004年1月至2006年8月,1397名入住我们ICU的患者被纳入这项观察性研究。这一时期分为两个阶段:ICIS实施前(BEFORE)和ICIS实施后(AFTER)。我们比较了标准ICU患者的结局:死亡率、在ICU的住院时间、住院时间以及根据BEFORE和AFTER的再入院率。尽管AFTER阶段入院的患者比BEFORE阶段入院的患者病情更严重(简化急性生理学评分II:分别为32.1±17.5 vs. 30.5±18.5,p = 0.014),但他们在ICU的住院时间明显更短(8.4±15.2 vs. 6.8±12.9天;p = 0.048),而AFTER阶段入院患者的再入院率和死亡率相似(分别为4.4% vs. 4.2%;p = 0.86,以及9.6% vs 11.2%,p = 0.35)。我们观察到,ICIS的实施能够缩短ICU住院时间,而不改变其他患者结局。

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