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埃塞俄比亚西北部综合专科医院重症监护病房收治的创伤患者恢复时间延长及其预测因素:一项多中心回顾性随访研究,2022年

Prolonged time to recovery and its predictors among trauma patients admitted to the intensive care units in comprehensive specialized hospitals in Northwest Ethiopia: a multicenter retrospective follow-up study, 2022.

作者信息

Messelu Mengistu Abebe, Ayenew Temesgen, Alamneh Tesfa Sewunet, Demile Tiruye Azene, Shibabaw Aster Tadesse, Belayneh Asnake Gashaw

机构信息

Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Front Med (Lausanne). 2024 May 30;11:1366403. doi: 10.3389/fmed.2024.1366403. eCollection 2024.

Abstract

INTRODUCTION

A prolonged time to recovery in the intensive care units has adverse effects on both the patients and the healthcare providers. However, there is limited evidence in African countries, including Ethiopia. Therefore, this study aimed to assess the time to recovery and its predictors among trauma patients admitted to intensive care units.

METHODS

An institutional-based retrospective follow-up study was conducted on trauma patients hospitalized in intensive care units between 9 January 2019 and 8 January 2022. The charts of 450 patients were chosen using a simple random sampling technique. Data collection was conducted using smartphones and tablets. The data were then exported into STATA version 16 for analysis. The log-rank test and the Kaplan-Meier survival curve were fitted for analysis. An adjusted hazard ratio with 95% confidence intervals was reported to declare the strength of association between time to recovery and predictors in the multivariable Weibull regression analysis.

RESULTS

The overall incidence density rate of recovery was 6.53 per 100 person-day observations, with a median time to recovery of 10 days. Significant predictors of time to recovery included being on mechanical ventilation (AHR = 0.47, 95% CI: 0.34, 0.64), having a Glasgow Coma Scale (GCS) score between 9-12 and 13-15 (AHR = 1.58, 95% CI: 1.01, 2.47, and AHR = 1.66, 95% CI: 1.09, 2.53, respectively), experiencing polytrauma (AHR = 0.55, 95% CI: 0.39, 0.78), and having complications (AHR = 0.43, 95% CI: 0.31, 0.59).

CONCLUSION AND RECOMMENDATIONS

The incidence rate of recovery for trauma patients is lower than the national standard, and the median time to recovery is longer. Being on mechanical ventilation, mild and moderate GCS scores, polytrauma, and the presence of complications were significantly associated with prolonged time to recovery. Therefore, special attention has to be given to trauma patients who had polytrauma, complications, received mechanical ventilation, and had a lower GCS score.

摘要

引言

重症监护病房中恢复时间延长对患者和医护人员都会产生不利影响。然而,在包括埃塞俄比亚在内的非洲国家,相关证据有限。因此,本研究旨在评估入住重症监护病房的创伤患者的恢复时间及其预测因素。

方法

对2019年1月9日至2022年1月8日期间在重症监护病房住院的创伤患者进行了一项基于机构的回顾性随访研究。采用简单随机抽样技术选取了450例患者的病历。使用智能手机和平板电脑进行数据收集。然后将数据导出到STATA 16版本进行分析。采用对数秩检验和Kaplan-Meier生存曲线进行分析。在多变量威布尔回归分析中,报告了调整后的风险比及95%置信区间,以说明恢复时间与预测因素之间的关联强度。

结果

恢复的总体发病率密度为每100人日观察6.53例,中位恢复时间为10天。恢复时间的显著预测因素包括接受机械通气(调整后风险比=0.47,95%置信区间:0.34,0.64)、格拉斯哥昏迷量表(GCS)评分为9 - 12分和13 - 15分(调整后风险比分别为1.58,95%置信区间:1.01,2.47;以及1.66,95%置信区间:1.09,2.53)、遭受多发伤(调整后风险比=0.55,95%置信区间:0.39,0.78)和出现并发症(调整后风险比=0.43,95%置信区间:0.31,0.59)。

结论与建议

创伤患者的恢复发病率低于国家标准且中位恢复时间更长。接受机械通气、轻度和中度GCS评分、多发伤以及并发症的存在与恢复时间延长显著相关。因此,必须特别关注遭受多发伤、出现并发症、接受机械通气且GCS评分较低的创伤患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac16/11169834/76b1f2d8af0d/fmed-11-1366403-g001.jpg

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