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2019年伊朗重症监护病房患者的疾病严重程度对住院时间和治疗结果的影响

Severity of illness affecting the length of stay and outcomes in patients admitted to intensive care units, Iran, 2019.

作者信息

Setareh Mohammad, Alavi Negin Masoudi, Atoof Fatemeh

机构信息

Department of Medical Surgical Nursing, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.

Department of Biostatistics, Health Faculty, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

J Educ Health Promot. 2021 May 20;10:142. doi: 10.4103/jehp.jehp_780_20. eCollection 2021.

Abstract

BACKGROUND

Length of stay (LOS) and patients' outcome are two important indicators in intensive care units (ICUs). The severity of illness influences these variables and could have a predictive value in clinical settings. The impact of severity of illness on the LOS and outcomes in patients admitted to ICUs was investigated in a selected hospital in Iran in 2019.

MATERIALS AND METHODS

This research was a descriptive longitudinal study. Data were prospectively collected on 150 patients. The sequential organ failure assessment (SOFA) score, LOS, and demographic variables of the patients were recorded. Abbreviated mental test and Barthel index measuring activities of daily living questionnaires were completed at the time of the discharge from ICU and 1 month later to show the patient outcomes. Data analysis was performed using Chi-square test, -test, analysis of variance, Pearson's correlation, and linear and ordinal logistic regression with SPSS software version 16.

RESULTS

The mean of LOS was 11.21 ± 10.54 days. 24.7% of the patients were discharged from ICUs with optimal recovery, 49.3% with poor recovery, and 26% died in ICUs. One month after discharge, 67.6% of patients had optimal recovery, 24.3% had poor recovery, and 8.1% died. The SOFA score had a significant relation with LOS and patient outcomes in discharge and 1 month later. All the patients with SOFA score <5 survived, and all the patients with SOFA score more than 12 died.

CONCLUSIONS

The severity of illness had a significant relation with LOS and patient outcomes in the time of the discharge from ICU and 1 month later. It seems that the initial SOFA score of 12 and higher can be suggested as a cutoff point for poor prognosis in ICU patients.

摘要

背景

住院时间(LOS)和患者预后是重症监护病房(ICU)的两个重要指标。疾病严重程度会影响这些变量,并且在临床环境中可能具有预测价值。2019年在伊朗一家选定的医院对疾病严重程度对入住ICU患者的住院时间和预后的影响进行了调查。

材料与方法

本研究为描述性纵向研究。前瞻性收集了150例患者的数据。记录患者的序贯器官衰竭评估(SOFA)评分、住院时间和人口统计学变量。在患者从ICU出院时和出院1个月后完成简易精神状态检查表和测量日常生活活动的巴氏指数问卷,以显示患者的预后情况。使用卡方检验、t检验、方差分析、Pearson相关性分析以及SPSS 16.0软件进行线性和有序逻辑回归分析。

结果

平均住院时间为11.21±10.54天。24.7%的患者从ICU出院时恢复良好,49.3%恢复不佳,26%在ICU死亡。出院1个月后,67.6%的患者恢复良好,24.3%恢复不佳,8.1%死亡。SOFA评分与出院时和出院1个月后的住院时间及患者预后有显著关系。所有SOFA评分<5的患者均存活,所有SOFA评分超过12的患者均死亡。

结论

疾病严重程度与从ICU出院时及出院1个月后的住院时间和患者预后有显著关系。似乎可以建议将初始SOFA评分12及以上作为ICU患者预后不良的临界点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4088/8224510/91e3a02b1783/JEHP-10-142-g001.jpg

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