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重症监护病房入院和出院时间的预后影响。

Prognostic impact of the time of admission and discharge from the intensive care unit.

作者信息

Moreira Héctor Eduardo, Verga Federico, Barbato Marcelo, Burghi Gastón

机构信息

Terapia Intensiva, Hospital Maciel - Montevideo, Uruguay.

出版信息

Rev Bras Ter Intensiva. 2017 Jan-Mar;29(1):63-69. doi: 10.5935/0103-507X.20170010.

Abstract

OBJECTIVE

: To determine the impact of the day and time of admission and discharge from the intensive care unit on mortality.

METHODS

: Prospective observational study that included patients admitted to the intensive care unit of the Hospital Maciel in Montevideo between April and November 2014.

RESULTS

: We analyzed 325 patients with an average age of 55 (36 - 71) years and a SAPS II value of 43 (29 - 58) points. No differences were found in the mortality of patients in the intensive care unit when time of admission (35% on the weekend versus 31% on weekdays, p = ns) or the hour of entry (35% at night versus 31% in the daytime, p = ns) were compared. The time of discharge was associated with higher hospital mortality rates (57% for weekend discharges versus 14% for weekday discharges, p = 0.000). The factors independently associated with hospital mortality after discharge from the intensive care unit were age > 50 years (OR 2.4, 95%CI, 1.1 - 5.4) and weekend discharge (OR 7.7, 95%CI, 3.8-15.6).

CONCLUSION

: This study identified the time of discharge from the intensive care unit as a factor that was independently associated with hospital mortality.

摘要

目的

确定重症监护病房的入院和出院日期及时间对死亡率的影响。

方法

前瞻性观察性研究,纳入2014年4月至11月间入住蒙得维的亚市马西埃尔医院重症监护病房的患者。

结果

我们分析了325例患者,平均年龄55(36 - 71)岁,简化急性生理学评分(SAPS II)为43(29 - 58)分。比较入院时间(周末入院为35%,工作日入院为31%,p = 无统计学意义)或入院小时数(夜间入院为35%,白天入院为31%,p = 无统计学意义)时,重症监护病房患者的死亡率无差异。出院时间与较高的医院死亡率相关(周末出院为57%,工作日出院为1%,p = 0.000)。重症监护病房出院后与医院死亡率独立相关的因素为年龄>50岁(比值比[OR] 2.4,95%置信区间[CI],1.1 - 5.4)和周末出院(OR 7.7,95%CI,3.8 - 15.6)。

结论

本研究确定重症监护病房的出院时间是与医院死亡率独立相关的一个因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff1/5385987/c183f4a0e679/rbti-29-01-0063-g01.jpg

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