Haruna Junpei, Masuda Yoshiki, Tatsumi Hiroomi, Sonoda Tomoko
Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan.
Department of Nursing, Tensei University, Sapporo 065-0013, Japan.
J Clin Med. 2022 Sep 2;11(17):5203. doi: 10.3390/jcm11175203.
This study evaluated the accuracy of predicting unplanned the intensive care unit (ICU) readmission using the Nursing Activities Score (NAS) at ICU discharge based on nursing workloads, and compared it to the accuracy of the prediction made using the Stability and Workload Index for Transfer (SWIFT) score. Patients admitted to the ICU of Sapporo Medical University Hospital between April 2014 and December 2017 were included, and unplanned ICU readmissions were retrospectively evaluated using the SWIFT score and the NAS. Patient characteristics, such as age, sex, the Charlson Comorbidity Index, and sequential organ failure assessment score at ICU admission, were used as covariates, and logistic regression analysis was performed to calculate the odds ratios for the SWIFT score and NAS. Among 599 patients, 58 (9.7%) were unexpectedly readmitted to the ICU. The area under the receiver operating characteristic curve of NAS (0.78) was higher than that of the SWIFT score (0.68), and cutoff values were 21 for the SWIFT and 53 for the NAS. Multivariate analysis showed that the NAS was an independent predictor of unplanned ICU readmission. The NAS was superior to the SWIFT in predicting unplanned ICU readmission. NAS may be an adjunctive tool to predict unplanned ICU readmission.
本研究基于护理工作量，评估了在重症监护病房（ICU）出院时使用护理活动评分（NAS）预测计划外ICU再入院的准确性，并将其与使用转运稳定性和工作量指数（SWIFT）评分进行预测的准确性进行比较。纳入了2014年4月至2017年12月期间入住札幌医科大学医院ICU的患者，并使用SWIFT评分和NAS对计划外ICU再入院进行回顾性评估。将患者特征，如年龄、性别、Charlson合并症指数以及ICU入院时的序贯器官衰竭评估评分用作协变量，并进行逻辑回归分析以计算SWIFT评分和NAS的比值比。在599例患者中，58例（9.7%）意外再入院至ICU。NAS的受试者工作特征曲线下面积（0.78）高于SWIFT评分（0.68），SWIFT评分的临界值为21，NAS的临界值为53。多变量分析显示，NAS是计划外ICU再入院的独立预测因素。在预测计划外ICU再入院方面，NAS优于SWIFT。NAS可能是预测计划外ICU再入院的辅助工具。
