Salluh Jorge I F, Quintairos Amanda, Dongelmans Dave A, Aryal Diptesh, Bagshaw Sean, Beane Abigail, Burghi Gaston, López Maria Del Pilar Arias, Finazzi Stefano, Guidet Bertrand, Hashimoto Satoru, Ichihara Nao, Litton Edward, Lone Nazir I, Pari Vrindha, Sendagire Cornelius, Vijayaraghavan Bharath Kumar Tirupakuzhi, Haniffa Rashan, Pisani Luigi, Pilcher David
D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Crit Care Med. 2024 Jan 1;52(1):125-135. doi: 10.1097/CCM.0000000000006050. Epub 2023 Sep 12.
Clinical quality registries (CQRs) have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. This narrative review describes the challenges, proposed solutions, and evidence generated by National ICU registries as facilitators for research and quality improvement.
English language articles were identified in PubMed using phrases related to ICU registries, CQRs, outcomes, and case-mix.
Original research, review articles, letters, and commentaries, were considered.
Data from relevant literature were identified, reviewed, and integrated into a concise narrative review.
CQRs have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. The initial experience in European countries and in Oceania ensured that through locally generated data, ICUs could assess their performances by using risk-adjusted measures and compare their results through fair and validated benchmarking metrics with other ICUs contributing to the CQR. The accomplishment of these initiatives, coupled with the increasing adoption of information technology, resulted in a broad geographic expansion of CQRs as well as their use in quality improvement studies, clinical trials as well as international comparisons, and benchmarking for ICUs.
ICU registries have provided increased knowledge of case-mix and outcomes of ICU patients based on real-world data and contributed to improve care delivery through quality improvement initiatives and trials. Recent increases in adoption of new technologies (i.e., cloud-based structures, artificial intelligence, machine learning) will ensure a broader and better use of data for epidemiology, healthcare policies, quality improvement, and clinical trials.
临床质量登记处（CQRs）已被多个医学专业在全球范围内采用，旨在更好地描述患者的流行病学特征、治疗情况和结局。国家重症监护病房（ICU）登记处创建于近30年前，以增进对危重症患者病例组合、资源利用和结局的了解。本叙述性综述描述了国家ICU登记处作为研究和质量改进促进因素所面临的挑战、提出的解决方案以及产生的证据。
在PubMed中使用与ICU登记处、CQRs、结局和病例组合相关的短语来识别英文文章。
考虑原创研究、综述文章、信函和评论。
识别、审查来自相关文献的数据，并将其整合到一篇简明的叙述性综述中。
多个医学专业已在全球范围内采用CQRs，旨在更好地描述患者的流行病学特征、治疗情况和结局。国家ICU登记处创建于近30年前，以增进对危重症患者病例组合、资源利用和结局的了解。欧洲国家和大洋洲的初步经验确保了通过本地生成的数据，ICU可以使用风险调整措施评估其绩效，并通过公平且经过验证的基准指标与其他参与CQRs的ICU比较结果。这些举措的完成，再加上信息技术的日益普及，导致CQRs在地理上广泛扩展，并用于质量改进研究、临床试验以及国际比较和ICU基准测试。
ICU登记处基于真实世界数据，增加了对ICU患者病例组合和结局的了解，并通过质量改进举措和试验有助于改善护理服务。最近新技术（即基于云的架构、人工智能、机器学习）采用率的提高将确保更广泛、更好地利用数据用于流行病学、医疗政策、质量改进和临床试验。
