Turcato Gianni, Zaboli Arian, Filippi Lucia, Cipriano Alessandro, Ferretto Paolo, Milazzo Daniela, Sabbà Giulia Elena, Maggi Michael, Marchetti Massimo, Wiedermann Christian Josef
Department of Internal Medicine, Intermediate Care Unit, Hospital Alto Vicentino (AULSS-7), Via Graziere 52, Santorso, Italy.
Innovation, Research and Teaching Service (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy.
Intern Emerg Med. 2025 Mar;20(2):453-461. doi: 10.1007/s11739-024-03820-3. Epub 2024 Nov 21.
The progressive reduction of acute care beds will necessitate hospital admission in medical settings solely for acutely ill patients requiring urgent organ support. Early stabilization of the acute condition, potentially through an appropriate treatment unit, may not only improve short-term patient outcomes but also reduce the length of hospital stay. To determine if stabilization of the acute condition in an intermediate care unit (IMCU) is associated with improved patient outcomes and reduced in-hospital stay. A prospective exploratory pilot observational study was conducted at the Department of Internal Medicine of the Alto Vicentino Hospital (Italy), including all patients admitted for non-intensive acute conditions between September and December 2022. The primary endpoint of the study was stabilization of the acute condition within 72 h of admission. Three hundred twenty four patients were enrolled. 73.5% (238/324) of patients achieved stabilization at 72 h, compared to 26.5% (86/324) who did not achieve stabilization. Among the variables found to be significant in the multivariate analysis, admission to the IMCU was associated with achieving stabilization within 72 h with an odds ratio of 2.28 (95% CI 1.29-4.01, p < 0.004). Meanwhile, for 30-day mortality, patient stabilization was found to be protective with an odds ratio of 0.11 (95% CI 0.04-0.29, p < 0.001). Early stabilization is associated with lower 30-day mortality and shorter lengths of stay. Treatment in an IMCU shows higher rates of 72-h stabilization.
急性护理床位的逐步减少将使得医院仅收治需要紧急器官支持的急重症患者。通过合适的治疗单元对急性病情进行早期稳定处理，不仅可能改善患者的短期预后，还能缩短住院时间。为了确定在中级护理单元（IMCU）对急性病情进行稳定处理是否与改善患者预后及缩短住院时间相关。在意大利阿尔托维琴蒂诺医院内科进行了一项前瞻性探索性试点观察研究，纳入了2022年9月至12月期间因非重症急性病情入院的所有患者。该研究的主要终点是入院72小时内急性病情的稳定。共纳入324例患者。73.5%（238/324）的患者在72小时时实现了病情稳定，而未实现稳定的患者占26.5%（86/324）。在多变量分析中发现具有显著意义的变量中，入住IMCU与在72小时内实现病情稳定相关，比值比为2.28（95%可信区间1.29 - 4.01，p＜0.004）。同时，对于30天死亡率，发现患者病情稳定具有保护作用，比值比为0.11（95%可信区间0.04 - 0.29，p＜0.001）。早期病情稳定与较低的30天死亡率和较短的住院时间相关。在IMCU进行治疗显示72小时病情稳定率更高。
