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巴西内陆一家二级医院设立重症监护病房后,因呼吸系统疾病住院患者的死亡率降低。

Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil.

作者信息

Diogo Luciano Passamani, Bahlis Laura Fuchs, Wajner André, Waldemar Fernando Starosta

机构信息

Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BR.

Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BR.

出版信息

Rev Bras Ter Intensiva. 2015 Jul-Sep;27(3):235-9. doi: 10.5935/0103-507X.20150043.

Abstract

OBJECTIVE

To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units.

METHODS

This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student's t test, Mann-Whitney test, and logistic regression.

RESULTS

Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021).

CONCLUSION

Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.

摘要

目的

评估因呼吸系统疾病住院患者的院内死亡率与重症监护病房可用性之间的关联。

方法

这项回顾性队列研究评估了一家医院内科服务的数据库,该数据库涉及因呼吸系统非终末期疾病住院的患者。收集了与死亡率相关的临床特征和风险因素数据,如查尔森评分和住院时间。进行了以下分析:使用曼特尔-亨塞尔检验、卡方检验、学生t检验、曼-惠特尼检验和逻辑回归进行简单分层的单变量分析。

结果

共选取313例患者,其中重症监护病房安装前98例(31.3%),安装后215例(68.7%)。两组在临床、人体测量特征或风险因素方面未观察到显著差异。重症监护病房安装前死亡率为18/95(18.9%),安装后为21/206(10.2%)。逻辑回归分析表明,重症监护病房安装后死亡概率降低了58%(比值比:0.42;95%置信区间0.205 - 0.879;p = 0.021)。

结论

考虑到研究的局限性,结果表明存在益处,即我院安装重症监护病房后,每治疗11例呼吸系统疾病患者可减少1例死亡。结果证实了二级医院实施重症监护病房的益处。

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Mortality and denial of admission to an intensive care unit.死亡率与重症监护病房的入院拒绝
Am J Respir Crit Care Med. 2012 May 15;185(10):1038-40. doi: 10.1164/rccm.201202-0343ED.

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