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重症监护医生的值班安排与新冠肺炎危重症患者的预后:一项基于人群的队列研究。

Intensivist coverage and critically ill COVID-19 patient outcomes: a population-based cohort study.

作者信息

Oh Tak Kyu, Kim Saeyeon, Song In-Ae

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-Ro, 173, Beon-Gil, Bundang-Gu, Seongnam, 13620, South Korea.

Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.

出版信息

J Intensive Care. 2023 May 12;11(1):19. doi: 10.1186/s40560-023-00668-1.

Abstract

BACKGROUND

Trained intensivist staffing improves survival outcomes in critically ill patients at intensive care units. However, the impact on outcomes of critically ill patients with coronavirus disease 2019 has not yet been evaluated. We aimed to investigate whether trained intensivists affect outcomes among critically ill coronavirus disease 2019 patients in South Korean intensive care units.

METHODS

Using a nationwide registration database in South Korea, we included adult patients admitted to the intensive care unit from October 8, 2020, to December 31, 2021, with a main diagnosis of coronavirus disease 2019. Critically ill patients admitted to intensive care units that employed trained intensivists were included in the intensivist group, whereas all other critically ill patients were assigned to the non-intensivist group.

RESULTS

A total of 13,103 critically ill patients were included, with 2653 (20.2%) patients in the intensivist group and 10,450 (79.8%) patients in the non-intensivist group. In the covariate-adjusted multivariable logistic regression model, the intensivist group exhibited 28% lower in-hospital mortality than that of the non-intensivist group (odds ratio: 0.72; 95% confidence interval: 0.62, 0.83; P < 0.001).

CONCLUSIONS

Trained intensivist coverage was associated with lower in-hospital mortality among critically ill coronavirus disease 2019 patients who required intensive care unit admission in South Korea.

摘要

背景

在重症监护病房配备经过培训的重症医学专家可改善重症患者的生存结局。然而,其对2019冠状病毒病重症患者结局的影响尚未得到评估。我们旨在调查在韩国重症监护病房中,经过培训的重症医学专家是否会影响2019冠状病毒病重症患者的结局。

方法

利用韩国的一个全国性登记数据库,我们纳入了2020年10月8日至2021年12月31日期间入住重症监护病房、主要诊断为2019冠状病毒病的成年患者。入住配备经过培训的重症医学专家的重症监护病房的重症患者被纳入重症医学专家组,而所有其他重症患者被分配到非重症医学专家组。

结果

共纳入13103例重症患者,其中重症医学专家组有2653例(20.2%),非重症医学专家组有10450例(79.8%)。在协变量调整的多变量逻辑回归模型中,重症医学专家组的院内死亡率比非重症医学专家组低28%(比值比:0.72;95%置信区间:0.62,0.83;P < 0.001)。

结论

在韩国,对于需要入住重症监护病房的2019冠状病毒病重症患者,配备经过培训的重症医学专家与较低的院内死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4355/10182706/0098954cdcd8/40560_2023_668_Fig1_HTML.jpg

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