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韩国快速反应团队筛查并转入重症监护病房患者的特征和结局。

Characteristics and outcomes of patients screened by the rapid response team and transferred to intensive care unit in South Korea.

机构信息

Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.

Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

出版信息

Sci Rep. 2024 Oct 23;14(1):25061. doi: 10.1038/s41598-024-75432-y.

Abstract

The rapid response system (RRS) is associated with a reduction in in-hospital mortality. This study aimed to determine the characteristics and outcomes of patients transferred to the intensive care unit (ICU) by a rapid response team (RRT). This retrospective, multicenter cohort study included patients from nine hospitals in South Korea. Adult patients who were admitted to the general ward (GW) and required RRS activation were included. Patients with do-not-resuscitate orders and without lactate level or Sequential Organ Failure Assessment score were excluded. A total of 8228 patients were enrolled, 3379 were transferred to the ICU. The most common reasons for RRT activation were respiratory distress, sepsis and septic shock. The number of patients who underwent interventions, the length of hospital stays, 28-day mortality, and in-hospital mortality were higher in the ICU group than in the GW group. Factors that could affect both 28-day and in-hospital mortality included the severity score, low PaO/FiO ratio, higher lactate and C-reactive protein levels, and hospitalization time prior to RRT activation. Patients admitted to the ICU after RRT activation generally face more challenging clinical situations, which may affect their survival outcomes.

摘要

快速反应系统(RRS)与院内死亡率的降低有关。本研究旨在确定通过快速反应团队(RRT)转至重症监护病房(ICU)的患者的特征和结局。这是一项回顾性、多中心队列研究,纳入了韩国 9 家医院的患者。纳入标准为入住普通病房(GW)且需要 RRS 激活的成年患者。排除有不复苏医嘱且无乳酸水平或序贯性器官衰竭评估评分的患者。共纳入 8228 例患者,其中 3379 例转至 ICU。RRT 激活的最常见原因是呼吸窘迫、败血症和败血症性休克。在 ICU 组中,接受干预的患者人数、住院时间、28 天死亡率和院内死亡率均高于 GW 组。可能影响 28 天和院内死亡率的因素包括严重程度评分、低 PaO/FiO 比值、更高的乳酸和 C 反应蛋白水平以及 RRT 激活前的住院时间。接受 RRT 激活后入住 ICU 的患者通常面临更具挑战性的临床情况,这可能会影响他们的生存结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf7/11499879/fa83814ddf53/41598_2024_75432_Fig1_HTML.jpg

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