基于专科信息系统建立的重症医学数据库:大型三甲医院重症医学数据库的模式

Introduction of critical care database based on specialized information systems: a model of critical care medicine database in large Level Ⅲ Grade A hospital

目的进一步完善科室信息系统,建立多参数重症医学数据库,为重症医学大数据分析研究提供资料,为其他医疗机构建立相关数据库提供参考。方法在充分了解科室临床及科研工作需要的前提下,解放军总医院第一医学中心重症医学科基于重症医学临床信息系统,整合了医院信息系统(HIS)、电子病历系统(EMR)、监护信息系统(Moniter)、检验信息系统(LIS)、放射信息系统(RIS)中患者的病例资料,初步建立了重症医学数据库。在此基础上进行相关数据分析及验证;并对比重症医学监护信息数据库(MIMIC-Ⅲ)而逐步完善其内容及架构。结果在2017年9月至2020年2月重症医学临床信息系统运行期间,该重症医学数据库共纳入2207例次重症患者的诊疗信息,包括患者进入重症监护病房(ICU)前及在ICU期间的全部数据,如人口统计学信息、生命体征、药物治疗、出入量记录、样本采集时间、实验室检查结果、手术治疗和多种临床常用评分数据及诊断等。所收集的数据按照内容不同分别储存至不同的数据表中,各表通过主键相互连接。数据库中收集的数据可经信息系统进行初步统计分析,并已经用于部分临床研究,可将临床与科研紧密结合。结论基于重症医学临床信息系统建立的重症医学数据库,可为医疗机构进行重症患者规范化治疗和临床研究提供帮助;其功能的进一步完善可以更好地适用于我国危重患者人群的数据分析。

Objective To further improve the department information system,and to establish a multi-parameter critical care medicine database,which can provide data for the analysis and research of big data in critical care medicine,and provide references for other medical institutions to establish relevant databases.Methods On the premise of fully understanding the needs of clinical and scientific research,based on a Critical Care Medicine Clinical Information System,the department of critical care medicine of the First Medical Center of Chinese PLA General Hospital integrated the patients'case data in hospital information system(HIS),electronic medical records(EMR),monitoring information system(Monitor),laboratory information system(LIS),and radiation information system(RIS),to establish a rudimentary critical care database.On this basis,the related data were analyzed and verified.Further,this database was gradually improved in both its content and structure by referring to Medical Information Mart for Intensive CareⅢ(MIMIC-Ⅲ)database.Results During the operation of Critical Care Medicine Clinical Information System from September 2017 to February 2020,the database collected diagnosis and treatment data of 2207 critically ill patients,including data before the patient entering the intensive care unit(ICU)and all data during the ICU,such as demographic data,vital signs,medical treatment,the records of intake and output,sampling time,laboratory examination results,surgical treatment,and a variety of commonly used clinical scoring and diagnosis data.The data in the database were stored in different tables according to different contents,and the tables were connected to each other through the primary key.The data could be analyzed statistically through the information system and has been applied for certain clinical studies,combining clinical practices with scientific studies.Conclusions The critical care medicine database based on the Critical Care Medicine Clinical Information System can help medical institutions to carry out standardized treatment and clinical research of critically ill patients.With further improvement of the function,the database can be better applied to the data analysis of Chinese critical patients.