Department of Respiratory Medicine and Allergology, Goethe University, Frankfurt, Germany
Department of Gastroenterology, Goethe University, Frankfurt, Germany.
BMJ Open. 2023 Jul 9;13(7):e069834. doi: 10.1136/bmjopen-2022-069834.
The objective of this study was to evaluate epidemiological characteristics, clinical course and outcome of mechanically ventilated non-surgical intensive care unit (ICU) patients, with the aim of improving the strategic planning of ICU capacities.
We conducted a retrospective observational cohort analysis. Data from mechanically ventilated intensive care patients were obtained by investigating electronic health records. The association between clinical parameters and ordinal scale data of clinical course was evaluated using Spearman correlation and Mann-Whitney U test. Relations between clinical parameters and in-hospital mortality rates were examined using binary logistic regression analysis.
A single-centre study at the non-surgical ICU of the University Hospital of Frankfurt, Germany (tertiary care-level centre).
All cases of critically ill adult patients in need of mechanical ventilation during the years 2013-2015 were included. In total, 932 cases were analysed.
From a total of 932 cases, 260 patients (27.9%) were transferred from peripheral ward, 224 patients (24.1%) were hospitalised via emergency rescue services, 211 patients (22.7%) were admitted via emergency room and 236 patients (25.3%) via various transfers. In 266 cases (28.5%), respiratory failure was the reason for ICU admission. The length of stay was higher in non-geriatric patients, patients with immunosuppression and haemato-oncological disease or those in need of renal replacement therapy. 431 patients died, which corresponds to an all-cause in-hospital mortality rate of 46.2%. 92 of 172 patients with presence of immunosuppression (53.5%), 111 of 186 patients (59.7%) with pre-existing haemato-oncological disease, 27 of 36 patients (75.0%) under extracorporeal membrane oxygenation (ECMO) therapy, and 182 of 246 patients (74.0%) undergoing renal replacement therapy died. In logistic regression analysis, these subgroups and older age were significantly associated with higher mortality rates.
Respiratory failure was the main reason for ventilatory support at this non-surgical ICU. Immunosuppression, haemato-oncological diseases, the need for ECMO or renal replacement therapy and older age were associated with higher mortality.
本研究旨在评估非外科重症监护病房（ICU）机械通气患者的流行病学特征、临床病程和转归，旨在改善 ICU 能力的战略规划。
我们进行了回顾性观察队列分析。通过调查电子健康记录获取机械通气重症监护患者的数据。使用 Spearman 相关和 Mann-Whitney U 检验评估临床参数与临床病程序数量表数据之间的关联。使用二元逻辑回归分析检查临床参数与住院死亡率之间的关系。
德国法兰克福大学非外科 ICU 的单中心研究（三级护理中心）。
纳入 2013-2015 年期间需要机械通气的所有成年危重症患者。共分析了 932 例病例。
在总共 932 例患者中，260 例（27.9%）从外围病房转来，224 例（24.1%）通过紧急救援服务入院，211 例（22.7%）通过急诊室入院，236 例（25.3%）通过各种转院入院。266 例（28.5%）因呼吸衰竭而入住 ICU。非老年患者、免疫抑制患者、血液肿瘤患者或需要肾脏替代治疗的患者住院时间较长。431 例患者死亡，总病死率为 46.2%。172 例免疫抑制患者中有 92 例（53.5%）、186 例血液肿瘤疾病患者中有 111 例（59.7%）、36 例体外膜氧合（ECMO）治疗患者中有 27 例（75.0%）、246 例肾脏替代治疗患者中有 182 例（74.0%）死亡。Logistic 回归分析显示，这些亚组和年龄较大与死亡率较高显著相关。
呼吸衰竭是该非外科 ICU 进行通气支持的主要原因。免疫抑制、血液肿瘤疾病、需要 ECMO 或肾脏替代治疗以及年龄较大与死亡率较高相关。
