Yumoto Tetsuya, Hongo Takashi, Obara Takafumi, Ageta Kohei, Aokage Toshiyuki, Tsukahara Kohei, Nakao Atsunori, Naito Hiromichi
Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan.
J Clin Med. 2024 Jul 24;13(15):4324. doi: 10.3390/jcm13154324.
: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. : This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. : The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04-1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. : Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management.
多学科团队会议(MDTMs)在重症监护病房(ICU)中至关重要。然而,由于时间限制和病例的复杂性,日常查房可能无法解决所有敏感问题。本研究旨在描述ICU中临时MDTMs的详细信息和特征。:这项单中心回顾性研究分析了2019年1月1日至2023年12月31日期间冈山大学医院成人急诊ICU的入院患者。在此期间,2020年6月引入了每周一次的常规多学科团队ICU查房,2022年4月开始了工作日上午的常规MDTMs。应用多元逻辑回归分析来确定这些变化对临时MDTMs频率的影响,并对包括年度变化在内的变量进行调整。:该研究分析了2487例成人急诊ICU患者,中位年龄为66岁,其中63.3%为男性。为168例患者(6.8%)召开了MDTMs,这些患者通常病情严重,包括较高的新冠肺炎患病率和急性生理与慢性健康状况评分系统(APACHE II)得分,以及较长的ICU住院时间。尽管MDTMs的总数保持不变,但进行临时MDTMs的可能性逐年增加(调整后的比值比为1.19;95%置信区间为1.04 - 1.35)。在为这些患者召开的329次MDTMs中,59.0%涉及临终关怀,平均有11名参与者,主要是护士以及急诊和重症监护医生。:ICU查房和会议结构的变化可能与临时MDTMs召开频率的提高有关,凸显了它们在患者护理管理中不断演变的作用和重要性。