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本文引用的文献

1
QUIT EMR trial: a prospective, observational, multicentre study to evaluate quality and 24 hours post-transport morbidity of interhospital transportation of critically ill patients: study protocol.QUIT EMR试验：一项前瞻性、观察性、多中心研究，旨在评估重症患者院际转运的质量和转运后24小时发病率：研究方案
BMJ Open. 2017 Mar 10;7(3):e012861. doi: 10.1136/bmjopen-2016-012861.
2
Into the out: safety issues in interhospital transport of the critically ill.从院内到院外：危重症患者院际转运中的安全问题
Intensive Care Med. 2016 Aug;42(8):1267-9. doi: 10.1007/s00134-016-4386-4. Epub 2016 May 20.
3
Nurses versus physician-led interhospital critical care transport: a randomized non-inferiority trial.护士主导与医生主导的院际重症监护转运：一项随机非劣效性试验。
Intensive Care Med. 2016 Jul;42(7):1146-54. doi: 10.1007/s00134-016-4355-y. Epub 2016 May 11.
4
Short-term outcomes and mortality after interhospital intensive care transportation: an observational prospective cohort study of 368 consecutive transports with a mobile intensive care unit.医院间重症监护转运后的短期结局和死亡率：一项对368例连续使用移动重症监护单元进行转运的观察性前瞻性队列研究。
BMJ Open. 2015 Apr 28;5(4):e006801. doi: 10.1136/bmjopen-2014-006801.
5
The Interhospital Medical Intensive Care Unit Transfer Instrument Facilitates Early Implementation of Critical Therapies and Is Associated With Fewer Emergent Procedures Upon Arrival.医院间医疗重症监护病房转运工具有助于关键治疗的早期实施，并与到达后较少的紧急手术相关。
J Intensive Care Med. 2015 Sep;30(6):351-7. doi: 10.1177/0885066614521964. Epub 2014 Feb 6.
6
A comparison of Cohen's Kappa and Gwet's AC1 when calculating inter-rater reliability coefficients: a study conducted with personality disorder samples.科恩氏 κ系数与格瓦特氏 AC1 系数在计算评定者间信度系数时的比较：一项对人格障碍样本进行的研究。
BMC Med Res Methodol. 2013 Apr 29;13:61. doi: 10.1186/1471-2288-13-61.
7
Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress.提高手术室和围手术期护理中的患者安全：障碍、干预措施和加速进展的优先事项。
Br J Anaesth. 2012 Dec;109 Suppl 1:i3-i16. doi: 10.1093/bja/aes391.
8
Effect of non-clinical inter-hospital critical care unit to unit transfer of critically ill patients: a propensity-matched cohort analysis.非临床环境下重症患者医院间重症监护病房至重症监护病房转运的影响：一项倾向匹配队列分析。
Crit Care. 2012 Oct 3;16(5):R179. doi: 10.1186/cc11662.
9
Preventable mortality evaluation in the ICU.重症监护病房中可预防死亡率的评估
Crit Care. 2012 Dec 12;16(2):309. doi: 10.1186/cc11212.
10
Inter-hospital transport of critically ill patients; expect surprises.危重症患者的院际转运；意料之外，情理之中。
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医院间转运质量在默兹-莱茵河地区（QUIT-EMR）评分中的表现：一项交叉验证研究。

The QUality of Interhospital Transportation in the Euregion Meuse-Rhine (QUIT-EMR) score: a cross-validation study.

机构信息

Department of Intensive Care Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands

Simulation Center, Maastricht University Medical Centre+, Maastricht, The Netherlands.

出版信息

BMJ Open. 2021 Nov 19;11(11):e051100. doi: 10.1136/bmjopen-2021-051100.

DOI:10.1136/bmjopen-2021-051100
PMID:34799362
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8606780/
Abstract

OBJECTIVES

Interhospital transports of critically ill patients are high-risk medical interventions. Well-established parameters to quantify the quality of transports are currently lacking. We aimed to develop and cross-validate a score for interhospital transports.

SETTING

An expert panel developed a score for interhospital transport by a Mobile Intensive Care Unit (MICU), the QUality of Interhospital Transportation in the Euregion Meuse-Rhine (QUIT-EMR) score. The QUIT-EMR score is an overall sum score that includes component scores of monitoring and intervention variables of the neurological (proxy for airway patency), respiratory and circulatory organ systems, ranging from -12 to +12. A score of 0 or higher defines an adequate transport. The QUIT-EMR score was tested to help to quantify the quality of transport.

PARTICIPANTS

One hundred adult patients were randomly included and the transport charts were independently reviewed and classified as adequate or inadequate by four transport experts (ie, anaesthetists/intensivists).

OUTCOME MEASURES

Subsequently, the level of agreement between the QUIT-EMR score and expert classification was calculated using Gwet's AC.

RESULTS

From April 2012 to May 2014, a total of 100 MICU transports were studied. The median (IQR) QUIT-EMR score was 1 (0-2). Experts classified six transports as inadequate. The percentage agreement between the QUIT-EMR score and experts' classification for adequate/inadequate transport ranged from 84% to 92% (Gwet's AC0.81-0.91). The interobserver agreement between experts was 87% to 94% (Gwet's AC0.89-0.98).

CONCLUSION

The QUIT-EMR score is a novel validated tool to score MICU transportation adequacy in future studies contributing to quality control and improvement.

TRIAL REGISTRATION NUMBER

NTR 4937.

摘要

目的

危重症患者的院内转运是高风险的医疗干预措施。目前缺乏量化转运质量的既定参数。我们旨在开发和交叉验证一种用于院内转运的评分系统。

设置

一个由移动重症监护单元（MICU）组成的专家小组开发了一种用于院内转运的评分系统，即默兹-莱茵河地区医院间转运质量评分（QUIT-EMR）。QUIT-EMR 评分是一个综合总分，包括神经系统（气道通畅性的替代指标）、呼吸系统和循环系统器官监测和干预变量的组成部分评分，范围从-12 到+12。评分 0 或更高定义为适当的转运。该评分系统用于帮助量化转运质量。

参与者

随机纳入了 100 名成年患者，由 4 名转运专家（即麻醉师/重症监护医师）独立审查并对转运图表进行适当或不适当的分类。

观察指标

随后，使用 Gwet 的 AC 计算 QUIT-EMR 评分与专家分类之间的一致性水平。

结果

2012 年 4 月至 2014 年 5 月，共研究了 100 例 MICU 转运。QUIT-EMR 评分中位数（IQR）为 1（0-2）。专家将 6 次转运归类为不适当。QUIT-EMR 评分与专家分类对适当/不适当转运的分类百分比范围为 84%至 92%（Gwet 的 AC0.81-0.91）。专家之间的观察者间一致性为 87%至 94%（Gwet 的 AC0.89-0.98）。

结论

QUIT-EMR 评分是一种新的验证工具，可用于未来的研究中对 MICU 转运的适当性进行评分，有助于质量控制和改进。

试验注册号

NTR 4937。