Chen S C, Cunneen S A, Colquhoun S D, Shabot M M
Burns and Allen Research Institute, Department of Surgery, Cedars-Sinai Medical Center, and the UCLA School of Medicine, Los Angeles, California 90048, USA.
Am Surg. 1998 Oct;64(10):926-9.
The outcome of surgical intensive care unit (SICU) care after nonemergent orthotopic liver transplantation (OLTX) was evaluated in 168 consecutive patients over a 6-year period (1/90-12/95). Prospective data collected included age, first and last SICU day Simplified Acute Physiology Score and Quantitative Therapeutic Intervention System Score, SICU length of stay (LOS), and mortality. The patient population was 61 per cent male and 39 per cent female, with ages ranging from 20 to 75 years. A total of four patients died in the SICU, for a mortality of 2.4 per cent. Over the study period, SICU LOS decreased by 21 per cent, from 3.9 +/- 0.7 to 3.1 +/- 0.3 days (P < 0.05). Although no difference in admission severity of illness was observed over the study period, there was an increase in the intensity of intervention performed on admission to the SICU. Over the study period, there was no difference in severity of illness or intensity of intervention upon discharge to floor care. The decreased SICU LOS did not adversely affect patient mortality or severity of illness upon SICU discharge during the 6-year period. With intensified SICU intervention, nonemergent orthotopic liver transplantation patients can have a shorter SICU LOS without adverse effects on outcome.
在6年期间（1990年1月至1995年12月），对168例连续接受非急诊原位肝移植（OLTX）的患者进行了外科重症监护病房（SICU）护理结局的评估。收集的前瞻性数据包括年龄、入住SICU首日和末日的简化急性生理学评分及定量治疗干预系统评分、SICU住院时间（LOS）和死亡率。患者群体中男性占61%，女性占39%，年龄范围为20至75岁。共有4例患者在SICU死亡，死亡率为2.4%。在研究期间，SICU的住院时间减少了21%，从3.9±0.7天降至3.1±0.3天（P<0.05）。尽管在研究期间观察到入院时疾病严重程度无差异，但入住SICU时进行的干预强度有所增加。在研究期间，转至普通护理病房时的疾病严重程度或干预强度无差异。在这6年期间，SICU住院时间的缩短并未对患者死亡率或SICU出院时的疾病严重程度产生不利影响。通过加强SICU干预，非急诊原位肝移植患者的SICU住院时间可以缩短，且对结局无不良影响。
