Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient outcomes.Existing predictive models for these reoperations lack precision in integrating complex clinical data.AIM To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients.METHODS Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected.Patients were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation occurrence.Patients were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve analysis.The risk scores of the two groups were calculated and compared to validate the model.RESULTS More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control group.Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(P<0.05):Prognostic Nutritional Index value,history of laparotomy,hypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists classification.Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility.CONCLUSION This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve treatment decisions and prognosis.

Predictive value of the unplanned extubation risk assessment scale in hospitalized patients with tubes

BACKGROUND Critical patients often had various types of tubes,unplanned extubation of any kind of tube may cause serious injury to the patient,but previous reports mainly focused on endotracheal intubation.The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or nonimplementation of unplanned extubation prevention interventions.To effectively identify and manage the risk of unplanned extubation,a comprehensive and universal unplanned extubation risk assessment tool is needed.AIM To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.METHODS This was a retrospective validation study.In this study,medical records were extracted between October 2020 and September 2021 from a tertiary comprehensive hospital in southwest China.For patients with tubes during hospitalization,the following information was extracted from the hospital information system:age,sex,admission mode,education,marital status,number of tubes,discharge mode,unplanned extubation occurrence,and the Huaxi Unplanned Extubation Risk Assessment Scale(HUERAS)score.Only inpatients were included,and those with indwelling needles were excluded.The best cut-off value and the area under the curve(AUC)of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified.RESULTS A total of 76033 inpatients with indwelling tubes were included in this study,and 26 unplanned extubations occurred.The patients’HUERAS scores were between 11 and 30,with an average score of 17.25±3.73.The scores of patients with or without unplanned extubation were 22.85±3.28 and 17.25±3.73,respectively(P<0.001).The results of the correlation analysis showed that the correlation coefficients between each characteristic and the total score ranged from 0.183 to 0.843.The best cut-off value was 21,and there were 14135 patients with a high risk of unplanned extubation,accounting for 18.59%.The Cronbach’sα,sensitivity,specificity,positive predictive value,and negative predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale were 0.815,84.62%,81.43%,0.16%,and 99.99%,respectively.The AUC of HUERAS was 0.851(95%CI:0.783-0.919,P<0.001).CONCLUSION The HUERAS has good reliability and predictive validity.It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.

Risk or Beneficial Factors Associated with Unplanned Revascularization Risk Following Percutaneous Coronary Intervention: A Large Single-Center Data

Objective To analyze factors associated with unplanned revascularization(UR) risk in patients with coronary artery disease(CAD) who underwent percutaneous coronary intervention(PCI).Methods A total of 10,640 cases with CAD who underwent PCI were analyzed. Multivariate COX regressions and competing risk regressions were applied.Results The patients who underwent UR following PCI in 30 days, 1, and 2 years accounted for 0.3%,6.5%, and 8.7%, respectively. After multivariate adjustment, the number of target lesions [hazard ratio(HR) = 2.320;95% confidence interval(CI): 1.643–3.277;P < 0.001], time of procedure(HR = 1.006;95%CI: 1.001–1.010;P = 0.014), body mass index(HR = 1.104;95% CI: 1.006–1.210;P = 0.036), incomplete revascularization(ICR)(HR = 2.476;95% CI: 1.030–5.952;P = 0.043), and age(HR = 1.037;95% CI:1.000–1.075;P = 0.048) were determined as independent risk factors of 30-day UR. Factors, including low-molecular-weight heparin or fondaparinux(HR = 0.618;95% CI: 0.531–0.719;P < 0.001), secondgeneration durable polymer drug-eluting stent(HR = 0.713;95% CI: 0.624–0.814;P < 0.001), left anterior descending artery involvement(HR = 0.654;95% CI: 0.530–0.807;P < 0.001), and age(HR = 0.992;95%CI: 0.985–0.998;P = 0.014), were independently associated with decreased two-year UR risk. While,Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score(HR =1.024;95% CI: 1.014–1.033;P < 0.001) and ICR(HR = 1.549;95% CI: 1.290–1.860;P < 0.001) were negatively associated with two-year UR risk.Conclusion Specific factors were positively or negatively associated with short-and medium-long-term UR following PCI.

Trauma Patient Unplanned Hospital Re-Admissions

Introduction: Performance monitoring and performance improvement (PI) are increasingly important. Little is known regarding unplanned re-admission (UPR) in trauma patients. This study characterizes UPRs at one institution. Methods: Retrospective descriptive review of UPR to a Level I Trauma Center Information was obtained on: initial trauma diagnoses, diagnosis precipitating UPR, discharge interval, treatment rendered and length of stay (LOS) during both encounters, and PI committee judgments. Characteristics of UPR patients were determined and compared to those of all discharged patients. Descriptive statistics were applied. Results: Over 2.5 years there were 2827 discharges and 58 UPR(2%). The majority of original diagnoses were related to blunt trauma and head injuries. UPR occurred at a median of 3 days, with 54% re-admitted to the trauma service. Operative rate for UPR patients during the initial admission was 48% with 28%requiring operation on the UPR. Headache and wound issues were responsible for 42% of UPR. Diagnosis precipitating UPR was primarily related to post-operative complications in 26% of all UPR and 57% of those undergoing operation on the initial admission. Median LOS for UPR was 3days with ICU care being required by 13%. Of all UPRs,33% were attributable to opportunities for improved care (OFI) during the first admission. Identified OFIs were related to errors in technique (53%), errors in judgment (27%), and system issues (20%). Of UPR without OFI, 87% were related to disease and13% systems issues. Conclusion: UPR at a Level I trauma center is rare, occurs shortly after discharge, is brief in duration and usually related to postoperative wound issues or headache. Post operative patients seem at greater risk for UPR. While most UPR are considered non-preventable, attention to discharge instructions,patient education, resident education and supervisionand outpatient support, may obviate a number of preventable UPRs.

The Effect of Unplanned Pregnancy among Women Collage in Wadajir Distract Moqdisho Somalia

Unplanned pregnancy is a pregnancy that is either mistimed or unwanted at the time of conception. It is a core concept in understanding the fertility of populations and the unmet need for contraception. Unintended pregnancy is associated with an increased risk of morbidity for women, and with health behaviors during pregnancy with adverse effects. And the aim of this study is to establish the level of effect of the unplanned pregnancy in women college in Wadajir district. This study used a cross-sectional study design. And the aim of this study is to establish the level of effect of the unplanned pregnancy on women college in Wadajir district. This study was being used cross sectional study design. This research had undertaken Wadajir district in Banadir region Mogadishu-Somalia. The sample size was 60 participating in the data collection phase from 1-30 Jun 2020. This study used primary data. This was collected from respondents in the area of study. Data was collected using a pre-cod structured questionnaire for the survey. Data showed that: 39 (65%) of the respondents answered yes that lack of education caused most unplanned pregnancy, 40 (66%) said that low-income countries are the risk factor of unplanned pregnancy, 47 (78%) of the respondents answered family planning is most common preventive for unplanned pregnancy, and 0 (67%) said that school dropout is the most compilation of unplanned pregnancy. Based on the findings of this research, the knowledge of the majority of respondents about unplanned pregnancy among women college replied yes, and they also replied that the most cause of unplanned pregnancy among women college is lack of education.

Re-operation for parotid gland cancer following non-standard surgical treatment

Objective:The purpose of this study was to analyze the clinical disadvantages of non-standard surgical treatment for parotid gland cancer and probe the re-operative indication following non-standard surgical treatment.Methods: Data of 58 cases suffered parotid gland cancer who received non-standard operation at other hospital and received re-operation in tumor hospital of Ganzhou from June 1998 to October 2010 were retrospectively reviewed.Results: In all cases,parotid gland cancer were residual in 46 cases,the facial nerve remaining rate was 81.0% (47/58),facial nerve branches injury rate was 3.5% (2/58),facial nerve partial resection rate was 8.6% (5/58) and total resection rate was 6.9% (4/58).The sensitivity of residual tumor was 83.3%,scanned by contrast-enhanced CT and the CT positive predictive value was 86.9%. Conclusion: Consideration of the higher residual tumor rate in patients who received non-standard operations,the re-operations were necessary.Contrast-enhanced CT positive predictive value was high for residual tumor and it was important for re-operation.

Modelling and Simulation of Performance of the Microgrid Frequency Stability Control during Unplanned Islanding: The Case Study of Mwenga Hydropower

A grid connected microgrid connects to the grid at a point of common coupling. Due to the great inertia of the grid which accelerates and decelerates the generator when its frequency tends to deviate, the grid connected microgrid operates at a frequency of the infinity bus. Frequency instability is one of the major challenges facing the grid connected microgrid during islanding. The power demand variation causes the variation in rotor speed, resulting to frequency deviation. Frequency can be brought back to standard by varying the power generation to match with the varying load. The performance of the frequency stability control system at Mwenga hydroelectric microgrid has been studied. Through site visitation, the power demand and generation status data were collected and analysed for model preparation. The results of the study indicate that, during islanding, the Mwenga rural electrification project is observed to be subjected to power imbalance which leads to frequency instability. Although the frequency control system tries to keep the system at a nominal frequency by maintaining the continuous balance between generation and varying load demand, however the system still operates with large magnitude of overshoot, undershoot and longer settling time.

Reducing the Rate of Unplanned Extubation of Venous Access in Perioperative Patients

Objective:To investigate the application effect of quality control circle activities in reducing the rate of unplanned extubation of venous access in perioperative patients.Methods:The quality control circle method was used to analyze the causes,identify the actual causes of unplanned out-of-control,take corresponding measures,formulate corresponding countermeasures,implement standardized management,and carry out continuous improvement.Results:Following the implementation of quality control circle activities,the rate of unplanned extubation of venous access in perioperative patients decreased from 27.35%before improvement to 3.42%after improvement.Conclusion:The use of quality control circle activities in the safety management of venous access in perioperative patients is conducive to reducing the rate of unplanned extubation of venous access in perioperative patients.

非计划再次手术原因及影响因素分析

目的 探讨非计划再次手术的原因及影响因素,为降低非计划再次手术率提供参考依据。方法 通过提取广西壮族自治区某三级甲等医院2022年1月至12月的手术资料,对该院非计划再次手术的一般情况、科室分布、主要原因以及患者的转归情况进行描述性分析,利用二分类logistic回归分析其影响因素。结果 该院2022年全年非计划再次手术共130例,发生率为0.35%。非计划再次手术患者以男性为主(63.08%),手术切口类型以0类切口为主(46.92%),手术等级以三、四级为主(80.77%),术者职称以副高级以上职称为主(88.46%)。常见原因为术后出血、未达到应有效果、病情需要、探查发病原因、出现漏或瘘,占50.00%。影响因素主要为性别、手术切口类型及手术切口愈合等级,其中男性(OR=1.733,P=0.006)、Ⅰ类手术切口(OR=2.909,P=0.004)及手术切口乙级愈合(OR=6.565,P <0.001)的患者更容易发生非计划再次手术。结论 医院应重视非计划再次手术的监管,针对围手术期存在的问题进行原因分析并持续改进,保障手术质量及患者安全。

ICU成人病人气管插管非计划性拔管风险评估工具研究进展

综述了ICU成人病人气管插管非计划性拔管风险评估工具,分析风险评估工具的优点及不足之处,并对使用情况进行总结,为护理工作者开展有效的气管插管非计划性拔管风险评估工作提供依据。

卒中后30d患者发生非计划再入院的影响因素分析

目的:分析卒中后30 d患者发生非计划再入院的影响因素。方法:选取2021年4月至2022年11月该院收治的102例卒中患者进行横断面研究,根据卒中后30 d是否发生非计划再入院将其分为再入院组(n=24)与非再入院组(n=78)。收集患者一般资料,并采用Logistic回归分析卒中后30 d患者发生非计划再入院的影响因素。结果:102例卒中后30 d患者发生非计划再入院24例,发生率为23.53%;单因素分析结果显示,两组性别、文化程度、婚姻状况、医疗费用支付方式、吸烟史、饮酒史、合并糖尿病、住院时间、体质量指数(BMI)等比较,差异均无统计学意义(P>0.05);再入院组年龄>70岁、合并高血压、合并高脂血症、服药依从性差、未接受院内康复等占比均高于非再入院组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,年龄>70岁、合并高血压、合并高脂血症等均为影响卒中后30 d患者发生非计划再入院的危险因素,服药依从性良好、接受院内康复等均为影响卒中后30 d患者发生非计划再入院的保护因素(P<0.05)。结论:年龄>70岁、合并高血压、合并高脂血症等均为影响卒中后30 d患者发生非计划再入院的危险因素,服药依从性良好、接受院内康复等均为影响卒中后30 d患者发生非计划再入院的保护因素。

某铜矿选矿车间非计划停车成因分析及改进措施

安徽某铜矿选矿车间为了减少非计划停车时长及提高设备运转率,针对该铜矿选矿车间非计划停车时长问题,对半自磨机、球磨机、碎矿系统、浮选系统非计划停车时长进行了统计及成因分析,发现半自磨机、球磨机故障及日常巡点检工作疏忽是导致选矿车间非计划停车的主要原因,并针对性地实施了一系列改进措施。通过将半自磨机筒体衬板材质由高锰钢更换为铬钼合金并优化其结构,将球磨机轴承零件更换为高质量材质并优化热处理工艺,加强日常巡点检工作管理等措施,显著减少了非计划停车事件,提升了设备运转效率,保障了生产安全,提高了企业经济效益。

下呼吸道感染儿童外周血免疫细胞动态变化与31天内非计划再入院的相关性研究

目的探究下呼吸道感染儿童外周血免疫细胞动态变化与31 d内非计划再入院的相关性。方法回顾性选择2021年12月至2023年12月在南京医科大学第四附属医院住院治疗的1081例下呼吸道感染患儿进行研究,根据治疗后31 d内非计划再入院情况,分为未再入院组(976例)和再入院组(105例)。比较2组患儿的临床资料;重复测量方差分析2组患儿免疫细胞水平;LOWESS分析免疫细胞水平与25%潮气量时的呼气流速(TEF 25)的曲线关系;多因素Logistic回归方法分析31 d内非计划再入院的危险因素,并对模型进行评价;限制性立方样条法分析免疫细胞水平与31 d内非计划再入院风险的关系。结果相比于未再入院组,再入院组的TEF 25水平明显更低[(61±9)ml/s比(70±9)ml/s],被动吸烟、户外活动时间<2 h/d、年抗菌药物使用≥3次比例、C反应蛋白(CRP)水平明显更高(均P<0.05)。2组免疫细胞水平在时间效应、组间效应、交互效应方面的差异均有统计学意义(均P<0.05)。LOWESS分析结果显示,免疫细胞水平与TEF 25之间具有一定的非线性关系。多因素Logistic回归分析结果显示,被动吸烟、户外活动时间<2 h/d、年抗菌药物使用≥3次、TEF 25、CRP水平、治疗前CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)T细胞比值水平是下呼吸道感染患儿31 d内非计划再入院的独立危险因素(均P<0.05)。建模数据中的数据点对模型参数估计不存在强影响性;各变量间无多重共线性;模型的区分能力、预测能力及有效性较高。限制性立方样条法分析结果显示,下呼吸道感染患儿31 d内非计划再入院风险与治疗前CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)T细胞比值水平存在负向线性关系,与CD_(8)^(+)T细胞水平存在正向线性关系。结论外周血免疫细胞动态变化与下呼吸道感染患儿31 d内非计划再入院具有明显相关性,临床上可通过监测外周血免疫细胞水平的变化,及时采取预防措施,以降低非计划再入院的发生率。

健康行为过程取向模型对缺血性脑卒中病人出院准备度的提升效果研究

目的:观察健康行为过程取向模型对缺血性脑卒中病人出院准备度的提升效果。方法:选取2021年2月—2024年1月江南大学附属医院神经内科收治的缺血性脑卒中病人152例作为研究对象,采用随机数字表法将病人分为研究组和常规组,各76例。常规组实施常规护理,研究组在常规组基础上实施健康行为过程取向模型下的护理干预,干预4周。比较两组干预前后出院指导质量、出院准备度、急诊就诊率、1个月非计划性再入院率等情况。结果:干预后,研究组出院准备度各维度评分均高于常规组,出院指导质量总分高于常规组,研究组急诊就诊率、1个月非计划性再入院率低于常规组,差异均有统计学意义(P<0.05)。结论:实施健康行为过程取向模型干预护理后,能帮助病人提升出院准备度,改善出院指导质量,减少病人非计划性再入院率等。

智能报警气管导管防滑脱装置的设计及应用

目的:设计智能报警气管导管防滑脱装置,并评价其临床应用效果。方法:选取2022年4月-5月镇江市某三级甲等医院恢复室收治的172例全身麻醉手术病人作为研究对象,将2022年4月的86例全身麻醉气管插管病人作为对照组,将2022年5月的86例全身麻醉气管插管病人作为观察组。对照组按照常规的气管插管方法协助置管及护理,观察组应用智能报警气管导管防滑脱装置协助气管导管固定。对两组病人气管导管移位或脱出情况、病人面部皮肤情况、病人咽喉痛发生情况及护士满意度进行比较。结果:观察组病人气管导管移位或脱出风险小于对照组,面部皮肤并发症发生率、咽喉痛程度低于对照组,护士满意度高于对照组,差异均有统计学意义(均P<0.05)。结论:使用智能报警气管导管防滑脱装置可减少病人气管导管移位或脱出,降低病人皮肤并发症发生率、咽喉痛程度,提高护士满意度。

罗斯曼指数对老年髋膝关节置换后非计划再入院和并发症的影响

背景:人工髋膝关节置换术在老年群体中有广泛应用,但临床中缺乏对患者非计划再次入院和术后并发症的准确预测方法。目的:探讨罗斯曼(Rothman)指数对老年髋膝关节置换患者术后非计划再入院和并发症的影响。方法:选择遵义市第一人民医院骨科一病区2020年12月至2022年12月接受择期髋、膝关节手术患者153例为研究对象,根据出院后90 d内是否非计划再次入院分为再入院组(n=21)和非再入院组(n=132)。通过电子病历系统统计所有患者一般性资料,包括性别、年龄、体质量指数、合并糖尿病、合并高血压、手术关节类型等,参照文献评估Rothman指数,统计患者术后并发症。结果与结论:①再入院组和非再入院组患者性别、体质量指数、手术关节类型、住院时长比较差异无显著性意义(P>0.05),两组共病数量、年龄、Rothman得分比较差异有显著性意义(P<0.05);②多因素Logistics回归分析结果显示,共病数量、年龄和Rothman得分均是老年髋、膝关节疾病患者术后90 d再入院的独立影响因素(P<0.05);③受试者工作特征曲线分析结果表明,Rothman指数预测人工髋膝关节置换术后90 d再入院曲线下面积为0.824,敏感度为80.85%,特异度为78.85%,最大youden指数为0.597,最佳截断值为46分;④Rothman<46分的老年患者总并发症发生率高于Rothman≥46分的老年患者(P<0.05);⑤提示Rothman指数可较为准确地预测老年髋、膝关节疾病患者术后非计划再入院,同时Rothman指数低于46分者发生并发症总体风险较高,关节恢复较差,可用于临床中改善患者术后管理。

三级医院老年患者出院延续护理转介单的设计及应用

目的设计三级医院老年患者出院延续护理转介单,评价其应用效果。方法参考文献资料,采用焦点小组讨论法,设计老年患者出院延续护理转介单,嵌入医院电子病历信息系统,病区护士使用转介单对有延续护理需求的患者进行转介,延续护理服务部专职护士接收转介,到病区为患者提供出院计划服务及出院后上门护理。结果2021-2022年全院21个老年患者所在科室均应用老年患者出院延续护理转介单实施转介,转介患者386例,其中80岁及以上老年患者219例(56.7%),内科系统9个科室共转介患者267例(69.2%)。为386例患者出院后1个月内提供上门护理服务597例次,患者出院30 d内非计划性再入院率为5.2%。结论设计及应用老年患者出院延续护理转介单,有利于促进转介及提高不同部门工作人员之间合作协调性,从而满足出院老年患者延续护理服务需求及降低出院后非计划性再入院率。

隧道式置管方式在降低肿瘤病人PICC非计划性拔管率的效果研究

目的:观察肿瘤病人在经外周置入中心静脉导管(PICC)治疗期间应用隧道式置管方式对降低非计划性拔管率的效果。方法:选取2023年1月—11月南昌大学第二附属医院肿瘤科初次行PICC置管治疗的80例肿瘤病人为研究对象,随机分为对照组、试验组,每组40例。对照组行传统置管方式,试验组行隧道式置管方式,比较两组病人一次穿刺成功率、非计划性拔管率、并发症发生率及生活质量[生活质量评定量表(QOL)评分]。结果:试验组病人一次穿刺成功率为90.00%,高于对照组的72.50%(P<0.05);试验组病人置管后90、120 d非计划性拔管率低于对照组(P<0.05);试验组并发症总发生率为5.00%,低于对照组的25.00%(P<0.05);干预后试验组病人QOL评分高于对照组(P<0.05)。结论:隧道式置管方式可提高肿瘤病人PICC一次穿刺成功率,减少并发症,降低非计划性拔管率,改善生活质量。

基于护理风险管理理论的康复科鼻饲患者非计划性拔管风险评估指标体系构建

目的构建科学的康复科鼻饲患者非计划性拔管(UEX)风险指标体系,为预防鼻饲患者非计划性拔管提供依据。方法通过文献回顾制定出康复科鼻饲患者UEX风险评估指标体系初稿,并应用德尔菲法对17名专家进行2轮函询,采用层次分析法确定各指标权重。结果2轮专家问卷回收有效率分别为100%、94.1%,专家权威程度分别为0.94、0.91,肯德尔协调系数分别为0.558和0.534(均P<0.001),最终形成康复科鼻饲患者UEX风险指标体系,包括一级指标3项,二级指标24项,三级指标60项。结论基于德尔菲法的康复科鼻饲患者UEX风险指标体系具有科学性和合理性,对指引临床工作具有重要意义。

早期预警自动评分程序在普通病区患者病情风险管控中的应用

目的探讨早期预警自动评分程序在普通病区患者病情风险管控中的应用效果。方法采用便利抽样法选取丰城市人民医院及丰城市妇幼保健院普通病房985名患者作为研究对象,其中2022年6月至12月住院的491例患者作为对照组,由护士进行人工早期预警评分;2023年1月至6月住院的494例患者作为观察组,由护士收集数据、早期预警自动评分程序进行高、中、低危分层,比较两组患者计算评分时间、非计划转入ICU及分级护理准确情况。结果观察组患者的计算评分时间短于对照组,差异有统计学意义(P<0.05)。观察组患者的非计划转入ICU率低于对照组,分级护理准确率高于对照组患者,差异有统计学意义(P<0.05)。结论早期预警自动评分程序对于普通病区患者危重症具有良好的区分能力,降低计算评分时间以及非计划转入ICU人数,提高分级护理准确度。