Emergency Department, University Hospital of Leipzig, Leipzig, Germany.
Medical Intensive Care Unit, University Hospital of Leipzig, Leipzig, Germany.
Anaesthesiologie. 2022 Oct;71(10):774-783. doi: 10.1007/s00101-021-00962-3. Epub 2021 Apr 30.
Management of critically ill nontrauma (CINT) patients in the resuscitation room of the emergency department (ED) is very challenging. Detailed data describing the patient characteristics and management of this population are lacking. This observational study describes the epidemiology, management and outcome in CINT ED patients in the resuscitation room.
This prospective, single center observational study included all adult patients who were consecutively admitted to the ED resuscitation room during 2 periods of 1 year (September 2014-August 2015 vs. September 2017- August 2018). Patient characteristics, out-of-hospital/in-hospital treatment, admission-related conditions, time intervals for diagnostics and interventions and outcome were recorded using a self-developed questionnaire.
A total of 34,303 patients in the first and 35,039 patients in the second study period were admitted to the ED, of whom 532 and 457 patients, respectively, were admitted to the nontrauma resuscitation room due to acute life-threatening conditions. The patient characteristics did not differ significantly between the study periods (male: 58% vs. 59%, age: 68 ± 17 years vs. 65 ± 17 years). Time intervals for diagnostic and therapeutic interventions were similar. The CINT patients during the second study period were treated faster compared to the first study period (end of ED management: 53 ± 33 min vs. 41 ± 24 min, p < 0.0001). The 30-day all-cause mortality was comparable (34.0% vs. 36.3%).
Observation of critically ill patient management in the ED resuscitation room showed reliable results between both study periods. Structured ED management guidelines for CINT patients may provide comparable results at one institution.
在急诊科（ED）复苏室中对非创伤性危重病（CINT）患者进行管理极具挑战性。缺乏详细描述该人群患者特征和管理的资料。本观察性研究描述了 ED 复苏室中 CINT 患者的流行病学、管理和结局。
本前瞻性、单中心观察性研究纳入了在两个 1 年时间段（2014 年 9 月至 2015 年 8 月与 2017 年 9 月至 2018 年 8 月）期间连续收入 ED 复苏室的所有成年患者。使用自行设计的问卷记录患者特征、院外/院内治疗、入院相关情况、诊断和干预的时间间隔以及结局。
第一个研究期间共收入 34303 例患者，第二个研究期间共收入 35039 例患者，分别有 532 例和 457 例因急性危及生命的情况收入非创伤性复苏室。两个研究期间患者特征无显著差异（男性：58% 与 59%，年龄：68±17 岁与 65±17 岁）。诊断和治疗干预的时间间隔相似。与第一个研究期间相比，第二个研究期间 CINT 患者的治疗速度更快（ED 管理结束：53±33 分钟与 41±24 分钟，p<0.0001）。30 天全因死亡率相当（34.0%与 36.3%）。
在 ED 复苏室中观察危重病患者管理的结果在两个研究期间均可靠。为 CINT 患者制定的结构化 ED 管理指南可能在一个机构中提供相当的结果。
