Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada;
Department of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
Hosp Pediatr. 2020 Apr;10(4):347-352. doi: 10.1542/hpeds.2019-0260.
To explore characteristics of patients who were admitted to the intermediate care (IC) unit at a tertiary academic institution. In particular, we sought to compare the characteristics of IC patients who were transferred with the characteristics of those who were not transferred to PICU care and evaluate predictors of patient transfer.
Data were collected on all admitted IC patients between July 2016 and June 2018. Patients whose index IC admission was from the PICU were excluded. Data collected included demographics and physiologic characteristics: heart rate, respiratory rate, temperature, oxygen therapy, as well as Bedside Pediatric Early Warning System (BPEWS) score.
In this time period, 427 eligible patient visits occurred, with 66 patients (15.46%) being transferred to the PICU. Patients were commonly transferred early in their IC course (1.41 days into admission [0.66-3.87]); transferred patients had higher median admission BPEWS scores (7 [4.25-9] vs 5 [3-7]; < .01). In the univariate analysis, no individual physiologic characteristic was predictive for transfer. In the multivariate analysis, BPEWS ( < .001) and need for any form of respiratory support ( = .04) were significant predictive factors for transfer ( = 0.56).
The need for close monitoring of physiologic parameters remains paramount, especially in the first 48 hours of admission, in predicting the need for transfer from the IC to PICU. The need for any form of respiratory support is predictive of transfer. Situational awareness and assessment including BPEWS score is of critical importance.
探索入住三级学术机构中级护理（IC）病房患者的特点。特别是，我们试图比较转入儿科重症监护病房（PICU）与未转入 PICU 患者的特点，并评估患者转科的预测因素。
收集 2016 年 7 月至 2018 年 6 月期间所有入住 IC 病房的患者数据。排除从 PICU 转入的患者。收集的数据包括人口统计学和生理特征：心率、呼吸频率、体温、氧疗以及床边儿科早期预警系统（BPEWS）评分。
在此期间，有 427 例符合条件的患者就诊，其中 66 例（15.46%）转入 PICU。患者通常在 IC 治疗的早期转科（入院后 1.41 天[0.66-3.87]）；转入患者的入院 BPEWS 评分中位数更高（7 [4.25-9] vs 5 [3-7]；<.01）。在单变量分析中，没有单个生理特征可预测转科。在多变量分析中，BPEWS（<.001）和任何形式的呼吸支持需求（=.04）是转科的显著预测因素（ = 0.56）。
需要密切监测生理参数，尤其是在入院的前 48 小时内，以预测从 IC 转至 PICU 的需求。任何形式的呼吸支持需求都是转科的预测因素。对包括 BPEWS 评分在内的情况的了解和评估至关重要。
