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48小时内需要非计划重症监护病房再入院患者的现状及危险因素:一项中国的回顾性倾向匹配研究

Status and Risk Factors in Patients Requiring Unplanned Intensive Care Unit Readmission Within 48 Hours: A Retrospective Propensity-Matched Study in China.

作者信息

Yin Yan-Ling, Sun Mei-Rong, Zhang Kun, Chen Yu-Hong, Zhang Jie, Zhang Shao-Kun, Zhou Li-Li, Wu Yan-Shuo, Gao Peng, Shen Kang-Kang, Hu Zhen-Jie

机构信息

Department of ICU, the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, People's Republic of China.

Hebei Key Laboratory of Critical Disease Mechanism and Intervention, Shijiazhuang City, Hebei Province, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2023 Mar 11;16:383-391. doi: 10.2147/RMHP.S399829. eCollection 2023.

Abstract

AIM

This study investigated the current status and related risk factors of 48-hour unplanned return to the intensive care unit (ICU) to reduce the return rate and improve the quality of critical care management.

METHODS

Data were collected from 2365 patients discharged from the comprehensive ICU. Multivariate and 1:1 propensity score matching analyses were performed.

RESULTS

Forty patients (1.69%) had unplanned readmission to the ICU within 48 hours after transfer. The primary reason for return was respiratory failure (16 patients, 40%). Furthermore, respiratory failure (odds ratio [OR] = 5.994, = 0.02) and the number of organ failures (OR = 5.679, = 0.006) were independent risk factors for unplanned ICU readmission. Receiver operating characteristic curves were drawn for the predictive value of the number of organ injuries during a patient's unplanned transfer to the ICU (area under the curve [AUC] = 0.744, sensitivity = 60%, specificity = 77.5%).

CONCLUSION

The reason for patient transfer and the number of organ injuries during the process were independent risk factors for patients who were critically ill. The number of organs damaged had a predictive value on whether the patient would return to the ICU within 48 hours.

摘要

目的

本研究调查了重症监护病房(ICU)48小时内非计划重返的现状及相关危险因素,以降低重返率并提高重症护理管理质量。

方法

收集了2365例从综合ICU出院患者的数据。进行了多变量和1:1倾向评分匹配分析。

结果

40例患者(1.69%)在转出后48小时内非计划重返ICU。重返的主要原因是呼吸衰竭(16例患者,40%)。此外,呼吸衰竭(比值比[OR]=5.994,P=0.02)和器官衰竭数量(OR=5.679,P=0.006)是非计划重返ICU的独立危险因素。绘制了患者非计划转至ICU期间器官损伤数量预测价值的受试者工作特征曲线(曲线下面积[AUC]=0.744,敏感性=60%,特异性=77.5%)。

结论

患者转出原因及过程中的器官损伤数量是危重症患者的独立危险因素。器官受损数量对患者是否会在48小时内重返ICU具有预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4fde/10015949/479110428a4d/RMHP-16-383-g0001.jpg

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