Li Qiang, Wang Jiajiong, Liu Guomin, Xu Meng, Qin Yanguo, Han Qin, Liu He, Wang Xiaonan, Wang Zonghan, Yang Kerong, Gao Chaohua, Wang Jin-Cheng, Zhang Zhongheng
1 Orthopaedic Medical Centre, The Second Hospital of Jilin University, Changchun, Jilin, China.
2 Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
J Int Med Res. 2018 Oct;46(10):4071-4081. doi: 10.1177/0300060518781253. Epub 2018 Aug 30.
Objective To investigate the association between time from hospital admission to intensive care unit (ICU) admission (door to ICU time) and hospital mortality in patients with sepsis. Methods This retrospective observational study included routinely collected healthcare data from patients with sepsis. The primary endpoint was hospital mortality, defined as the survival status at hospital discharge. Door to ICU time was calculated and included in a multivariable model to investigate its association with mortality. Results Data from 13 115 patients were included for analyses, comprising 10 309 survivors and 2 806 non-survivors. Door to ICU time was significantly longer for non-survivors than survivors (median, 43.0 h [interquartile range, 12.4, 91.3] versus 26.7 h [7.0, 74.2]). In the multivariable regression model, door to ICU time remained significantly associated with mortality (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.006, 1.017) and there was a significant interaction between age and door to ICU time (OR 0.99, 95% CI 0.99, 1.00). Conclusion A shorter time from hospital door to ICU admission was shown to be independently associated with reduced hospital mortality in patients with severe sepsis and/or septic shock.
目的 探讨脓毒症患者从入院到入住重症监护病房(ICU)的时间(门到ICU时间)与医院死亡率之间的关联。方法 这项回顾性观察性研究纳入了脓毒症患者的常规收集的医疗保健数据。主要终点是医院死亡率,定义为出院时的生存状态。计算门到ICU时间并纳入多变量模型以研究其与死亡率的关联。结果 纳入13115例患者的数据进行分析,其中包括10309例幸存者和2806例非幸存者。非幸存者的门到ICU时间明显长于幸存者(中位数,43.0小时[四分位间距,12.4,91.3]对26.7小时[7.0,74.2])。在多变量回归模型中,门到ICU时间仍与死亡率显著相关(比值比[OR]1.11,95%置信区间[CI]1.006,1.017),且年龄与门到ICU时间之间存在显著交互作用(OR 0.99,95%CI 0.99,1.00)。结论 结果显示,严重脓毒症和/或脓毒性休克患者从医院门到入住ICU的时间较短与降低医院死亡率独立相关。