Department of Surgery, Wake Forest University School of Medicine, Medical Center Blvd., Winston Salem, NC, 27157, USA.
Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 51 N. 39th Street, MOB 1st Floor, Philadelphia, PA, 19104, USA.
Am J Surg. 2018 Apr;215(4):669-674. doi: 10.1016/j.amjsurg.2017.04.019. Epub 2017 Jun 10.
Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs.
SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded. Multivariable regression analysis was used for comparison between patients.
Non-boarders were older, observed on a later post ICU admission day and were more likely to be mechanically ventilated. Boarded patients were often seen at the end of rounds and for less time. Not being a boarder, age, APACHE II score on admission, vasopressor use, and positive pressure ventilation all predicted increased rounding time.
Surgical ICU patients boarding in non-preferred units are often seen at the end of rounds, result in a greater reliance upon telephone communication, and receive less bedside attention from ICU provider teams.
已证实，外科重症监护病房（SICU）患者在非指定的主治病房的 ICU 中转诊会增加并发症的发生率。我们假设当 SICU 患者安置在主治 ICU 和中转 ICU 时， ICU 查房的实践会有所不同。
在一家学术型四级医疗中心观察了 SICU 查房。记录了每位患者的查房时间和顺序，以及患者的数据和人口统计学信息。采用多变量回归分析对患者进行比较。
非中转患者年龄较大，在 ICU 入院后较晚的时间进行观察，并且更有可能接受机械通气。中转患者通常在查房结束时被观察，时间更短。未中转、年龄、入院时的急性生理学与慢性健康状况评分 II （APACHE II）评分、血管加压素的使用和正压通气都预测了查房时间的增加。
在非首选病房中转诊的外科重症监护病房患者通常在查房结束时被观察，更多地依赖电话沟通，并且从 ICU 医护团队那里获得的床边关注更少。
