患者48小时内重返ICU的原因分析  

Analysis of Reasons for Patients Returning to ICU within 48 Hours in a Hospital

作　　者：赵晶[1] 张清叶[1] 张健新 Zhao Jing;Zhang Qingye;Zhang Jianxin(Intensive Care Unit,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100071,China;不详)

机构地区：[1]首都医科大学附属北京同仁医院重症监护室,北京市100071

出　　处：《中国病案》2022年第10期9-12,共4页Chinese Medical Record

摘　　要：目的分析导致患者48小时内重返重症监护病房(ICU)的原因。方法以某院2018年1月15日至2020年12月20日从ICU转出至普通病房的患者病例资料为研究对象,根据患者48小时内是否再次返回ICU分为重返组55例、未返回组719例;统计重返组患者的主要诊断疾病构成,并分析导致患者重返ICU的危险因素。结果774例患者首次入住ICU时的入院诊断主要有13类,其中重返ICU患者占比最高的前三类诊断分别是心肺复苏后70.00%、多发伤并休克8.91%、有机磷农药中毒7.14%;Logistic模型结果显示:年龄增加、因心肺复苏后入住ICU、首次入住ICU时发生二次插管、首次机械通气时间较长、首次ICU住院时间较长、转出ICU时APACHEⅡ评分及Sofa评分较高是患者48小时内重返ICU的独立风险因素(P<0.05)。结论呼吸衰竭、心力衰竭、感染、休克直接影响患者是否重返ICU,且年龄、心肺复苏及患者发生二次插管等因素也可增加患者48小时内重返ICU的风险。Objective To analyze the etiology and risk factors of patients returning to ICU within 48 hours.Methods Taking the case data of patients transferred from the ICU to the general ward in a hospital as the research object,according to whether the patients returned to the ICU again within 48 hours,they were divided into 55 cases in the reentry group and 719 cases in the non-return group;And using single factor analysis method and multivariate analysis method to explore the risk factors of SPSS 25.0 software analysis leading to patients returning to ICU.Results Among the 774 patients,there were 13 main admission diagnoses,among which the top three main diagnoses with the highest proportion of patients returning to ICU were 70.00%after cardiopulmonary resuscitation 8.91%with multiple trauma and shock,and 7.14%in patients with organophosphorus pesticide poisoning;Logistic model results showed that age increase,admission to ICU after cardiopulmonary resuscitation,secondary intubation,longer duration of first mechanical ventilation,longer duration of first ICU stay,higher APACHEⅡscore and higher Sofa score when transferred out of ICU Independent risk factors for patients returning to the ICU within 48 hours(P<0.05).Conclusions Respiratory failure,heart failure,infection,and shock were the main reasons for patients to return to the ICU.At the same time,factors related to the patient’s age,the implementation of cardiopulmonary resuscitation,and the occurrence of secondary intubation could also significantly increase the risk of patients returning to the ICU within 48 hours.

关 键 词：重症监护病房 原因 危险因素 病案分析 

分 类 号：R197.323[医药卫生—卫生事业管理]