非计划重返重症监护病房的原因及危险因素分析  

The reasons and risk factors of unplanned re-admission to intensive care unit

作　　者：李超梁[1] 马婕[1] 

机构地区：[1]广东省江门市中心医院重症医学科,529030

出　　处：《中国医药》2014年第7期1057-1059,共3页China Medicine

摘　　要：目的分析非计划重返重症监护病房（ICU）患者的原因及危险因素。方法收集2009年1月至2013年12月所有入综合ICU的患者资料，比较非计划重返ICU（R组）和未重返ICU者（C组）的初始和首次转出的急性生理和慢性健康评分（APACHE Ⅱ）、首次住ICU机械辅助通气时间、ICU总住院时间等。结果非计划重返ICU患者首次转出ICU时APACHE Ⅱ评分高于非重返ICU者[（16±6）分比（15±10）分，P=0.019]，并且前者ICU总住院时间[12.0（6.0，18.5）d 比4.0（2.0，8.0）d，P=0.000]和首次住ICU机械通气时间[83.0（0.0，187.5）h比59.0（0.0，96.0）h，P=0.040]明显长于后者；非计划重返ICU的原因以呼吸问题（肺部感染及呼吸衰竭）为主，占51.5%（17/33）；而机械通气时间[比值比（OR）=2.434，95%置信区间（CI）：1.039～5.700，P=0.041]和首次住ICU时间（OR=5.102，CI：2.043～8.242，P=0.000）是非计划重返ICU的独立危险因素。结论非计划重返ICU的原因以呼吸问题为主。非计划重返ICU患者首次转出时的疾病严重程度高、首次住ICU时间长、机械通气时间长，其中机械通气时间和首次住ICU时间是非计划重返ICU的独立危险因素。ObjectiveTo observe the reasons and risk factors of unplanned readmission to intensive care unit （ICU）. MethodsWe collected information of patients admitted to the general ICU from January 2009 to December 2013 and we compared the following indicators between unplanned readmission group （group R） and nonreadmission group （group C）： acute physiology and chronic health evaluation Ⅱ scores （APACHE Ⅱ） of initial admission to ICU, APACHE Ⅱ scores of first discharge to other departments, ventilation time of initial ICU hospitalization, total length of stay in ICU. Results Compared with group C, the APACHE Ⅱ scores of initial discharge were higher [（15±6）scores vs （15±10）scores, P=0.019]; the length of ICU hospitalization[12.0（6.0,18.5）d vs 4.0（2.0, 8.0）d,P=0.000] and ventilation time [83.0（0.0,187.5）h vs 59.0（0.0, 96.0）h, P=0.040] were longer in group R. The main reason of unplanned readmission to ICU was respiratory problems [51.5%（17/33）]. The independent risk factors of unplanned readmission to ICU were ventilation time （OR=2.434,95%CI：1.0395.700,P=0.041） and length of first ICU hospitalization（OR=5.102,CI：2.0438.242,P=0.000）. ConclusionsThe main reason of unplanned readmission to ICU is respiratory problems.The severity of illness at initial discharge from ICU is worse in patients of unplanned readmission to ICU with longer stay of ICU.

关 键 词：非计划重返重症监护病房 原因 危险因素 

分 类 号：R473[医药卫生—护理学]