Arabian Sajed, Davoodi Ali, Karajizadeh Mehrdad, Naderi Najmeh, Bordbar Najmeh, Sabetian Golnar
Student Research Committee, Department of Health Information Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Health Information Technology, Varastegan Institute for Medical Sciences, Mashhad, Iran.
Bull Emerg Trauma. 2024;12(2):81-87. doi: 10.30476/BEAT.2024.102331.1508.
This study aimed to determine the rate of readmission for trauma patients in ICUs, as well as the factors that predict this outcome.
This retrospective cohort study was conducted at Emtiaz Hospital, a level I referral trauma center (Shiraz, Iran). It analyzed the ICU readmission rates among trauma patients over three years. The required data were extracted from the Iranian Intensive Care Registry (IICUR), which included patient demographics, injury severity, physiological parameters, and clinical outcomes. Statistical analysis was performed using SPSS version 25.0. Descriptive statistics and different statistical tests, such as T-tests, Mann-Whitney tests, Chi-square tests, and logistic binary regression test were utilized.
Among the 5273 patients discharged from the ICU during the study period, 195 (3.7%) were readmitted during the same hospitalization. Patients readmitted to the ICU had a significantly higher mean age (54.83±22.73 years) than those who were not readmitted (47.08 years, <0.001). Lower Glasgow Coma Scale (GCS) scores at admission and discharge were associated with ICU readmission, implying that neurological status and readmission risk were correlated with each other. Furthermore, respiratory challenges were identified as the leading cause of unexpected readmission, including respiratory failure, hypoxic respiratory failure, respiratory distress, and respiratory infections such as pneumonia. Injury patterns analysis revealed a higher frequency of poly-trauma and head and neck injuries among patients readmitted to the ICU.
This study underscored the importance of ICU readmission among trauma patients, with a high readmission rate during the same hospitalization. By developing comprehensive guidelines and optimizing discharge processes, healthcare providers could potentially mitigate ICU readmissions and associated complications, ultimately enhancing patient outcomes and resource utilization in trauma ICU settings. This research provided valuable insights to inform evidence-based practices and improve the quality of care delivery for trauma patients in intensive care settings.
本研究旨在确定重症监护病房（ICU）创伤患者的再入院率，以及预测这一结果的因素。
本回顾性队列研究在伊朗设拉子的一级转诊创伤中心埃姆蒂亚兹医院进行。分析了三年内创伤患者的ICU再入院率。所需数据从伊朗重症监护登记处（IICUR）提取，其中包括患者人口统计学、损伤严重程度、生理参数和临床结局。使用SPSS 25.0版进行统计分析。采用了描述性统计和不同的统计检验，如t检验、曼-惠特尼检验、卡方检验和逻辑二元回归检验。
在研究期间从ICU出院的5273例患者中，195例（3.7%）在同一住院期间再次入院。再次入住ICU的患者平均年龄（54.83±22.73岁）显著高于未再次入院的患者（47.08岁，P<0.001）。入院和出院时较低的格拉斯哥昏迷量表（GCS）评分与ICU再入院相关，这意味着神经状态和再入院风险相互关联。此外，呼吸问题被确定为意外再入院的主要原因，包括呼吸衰竭、低氧性呼吸衰竭、呼吸窘迫和肺炎等呼吸道感染。损伤模式分析显示，再次入住ICU的患者中多发伤以及头颈部损伤的发生率更高。
本研究强调了创伤患者ICU再入院的重要性，同一住院期间再入院率较高。通过制定全面的指南和优化出院流程，医疗服务提供者有可能减少ICU再入院及相关并发症，最终改善创伤ICU环境下的患者结局和资源利用。本研究提供了有价值的见解，为循证实践提供依据，并提高重症监护环境下创伤患者的护理质量。
