北京某医院分院区创伤监护病床数量需求分析  

Analysis of the number of beds required in trauma intensive care unit in the branch campus of a tertiary hospital in Beijing

作　　者：王储 张亚军[1] 李睿[1] 晋菲斐 王天兵[1] Wang Chu;Zhang Yajun;Li Rui;Jin Feifei;Wang Tianbing(Trauma Center,Peking University People’s Hospital,Beijing 101109,China)

机构地区：[1]北京大学人民医院创伤救治中心

出　　处：《中华急诊医学杂志》2023年第4期527-530,共4页Chinese Journal of Emergency Medicine

基　　金：北京大学人民医院研究与发展基金(RDH2021-05)。

摘　　要：目的严重创伤事件具有突发性、发生率低、无法预测, 重症监护病房设置多少重症监护床位数量才能够满足严重创伤救治的临床需求, 同时医疗资源得到合理利用?目前指南并未给出精确建议。为此, 以北京大学人民医院分院区创伤重症监护病床需求数量评估为例, 以期提出合理的监护床位数量。方法提取本院某分院区2022年1月至2022年6月的严重创伤患者, 统计每日所使用的重症监护床位数量。按照分布概率函数计算99%临床需求下的重症监护床位数量。结果 2022年1月至2022年6月, 共103名严重创伤患者接受了重症监护治疗, 年龄(51.47±16.06)岁, 年龄范围16~87岁, 其中男性74人, 女性29人。57人为车祸伤, 26人为高处坠落伤, 12人为跌倒摔伤, 4人为重物砸伤, 4人为锐器伤。ISS范围16~50。每日创伤重症监护病床使用数量为0~10张, 其分布符合泊松分布。按照概率函数计算, 当设置9张创伤重症监护床位时, 可以满足99.19%的严重创伤的临床使用需求。结论在严重创伤事件中, 需尽快将患者转运到有空置重症监护床位的医院。对于该分院区而言, 设置9张重症监护病房床位可满足99.19%的严重创伤救治临床需求。由此推论, 按照创伤中心建设的基本要求, 具备创伤中心的医院, 重症监护病房需要至少9张床位。需要注意, 严重创伤事件无法预测, 故床位数量需要定期评估, 以及时发现临床需求的变化。Objective Severe trauma events are emergent,with low incidence and unpredictable.Current guideline does not provide precise recommendations on how the trauma centers should arrange the number of beds in trauma intensive care units while making rational use of medical resources.We analyzed the trauma intensive care unit bed requirement in the branch campus of our hospital to propose a reasonable assessment.Methods Patients with severe trauma sent to the Intensive Care Unit of Peking University People's Hospital from January 2022 to June 2022 were collected.The daily number of patients received intensive care was counted.The bed requirement of the intensive care unit covering 99%of clinical needs was calculated based on the probability distribution function.Results From January 2022 to June 2022,103 patients with severe trauma[74 males and 29 females,aged(51.47±16.06)years,ranging 16 to 87 years]were included in the study.Among the 103 patients,57 were injured in traffi c accidents,26 fell from a high altitude,12 fell,4 were hit by heavy objects,and 4 were stabbed.TISS ranged from 16 to 50.The range of the daily bed requirement in the intensive care unit was 0–10,which was consistent with the Poisson distribution.According to the probability distribution function,nine trauma intensive care beds could meet 99.19%of clinical needs.Conclusions In severe traumatic events,patients need to be transferred to intensive care unit as soon as possible.For our branch campus,nine trauma intensive care beds can cover more than 99%of clinical needs.It follows that,in accordance with the basic requirements of trauma center construction,hospitals with trauma centers need at least 9 beds in intensive care units.However,traumatic events cannot be predicted;thus,the bed requirement needs to be regularly evaluated.

关 键 词：严重创伤 创伤重症监护 床位数量 精确评估 创伤救治需求 

分 类 号：R197.32[医药卫生—卫生事业管理]