目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受...目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价模型预测效果。结果英国国家早期预警评分(national early warning score,NEWS)、血氧饱和度、急诊B超、血管活性药物、机械通气是急诊科危重症患者发生病情不良事件的独立风险因素;血氧饱和度、携氧装置、Ⅲ类管路、护工参与转运是技术不良事件的独立风险因素(均P<0.05)。AUC分别为0.813,0.756。结论构建的急诊科危重症患者院内转运不良事件风险预测模型具有一定的参考价值。展开更多
目的针对急危重症患儿进行院际安全转运,探讨急危重症患儿在院际安全转运过程中的安全隐患以及影响因素。方法选取于泉州市儿童医院2021年2月—2022年12月重症医学科儿科重症监护病房(pediatric intensive care unit,PICU)进行院际转运...目的针对急危重症患儿进行院际安全转运,探讨急危重症患儿在院际安全转运过程中的安全隐患以及影响因素。方法选取于泉州市儿童医院2021年2月—2022年12月重症医学科儿科重症监护病房(pediatric intensive care unit,PICU)进行院际转运的急危重症患儿486例,其中2021年164例、2022年322例。以患儿转运病种的统计、转运中不良事件的发生率、原地抢救次数以及转运后入院治疗及转归情况进行记录与统计学分析,比较2021年与2022年院际安全转运情况,对其进行院际安全转运过程中的安全隐患与影响因素进行分析。结果2021年组与2022年组急危重症患儿的院际安全转运比较,两组患儿的转运病种差异无统计学意义(P>0.05);但转运过程不良事件发生比较,差异有统计学意义(P<0.05),2021年组与2022年组发生率分别为50.00%、7.76%,以2022年组较低。2021年组患儿原地抢救率为13.41%,而2022年组为3.42%(P<0.05),两组患儿在院际转运后转归情况均良好。结论急危重症患儿在院际安全转运过程中受外在因素和内在因素的影响,存在一定的安全隐患,但基本转运情况良好,可进一步通过安全风险控制提高院际转运的安全性。展开更多
Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large ...Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large number of critically ill children are transferred each day in China,the standard process of inter-hospital transport is not formulated.Methods:We retrospectively analyzed the data collected during transport.A total number of 9231 patients(≤14 years)who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1,2009 to June 30,2012 were included in the study.Results:Nearly half of the critically ill children were neonates(48.72%)and two thirds of the children were suffering from respiratory,neurological and cardiac diseases.Multivariate adjusted odds ratios(OR)and 95%confidence intervals(CI)were calculated using unconditional logistic regression.Mobilization time in non-working hours was longer than the working hours(OR=1.186,95%CI=1.059-1.329).Our study showed that mobilization time for neonates was shorter than that for older children(OR=0.801,95%CI=0.692-0.928).The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km(OR=0.427,95%CI=0.350-0.521).Referred patients in summer needed a significantly shorter mobilization time than in winter(OR=0.705,95%CI=0.616-0.806).Conclusion:Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.展开更多
文摘目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价模型预测效果。结果英国国家早期预警评分(national early warning score,NEWS)、血氧饱和度、急诊B超、血管活性药物、机械通气是急诊科危重症患者发生病情不良事件的独立风险因素;血氧饱和度、携氧装置、Ⅲ类管路、护工参与转运是技术不良事件的独立风险因素(均P<0.05)。AUC分别为0.813,0.756。结论构建的急诊科危重症患者院内转运不良事件风险预测模型具有一定的参考价值。
文摘目的针对急危重症患儿进行院际安全转运,探讨急危重症患儿在院际安全转运过程中的安全隐患以及影响因素。方法选取于泉州市儿童医院2021年2月—2022年12月重症医学科儿科重症监护病房(pediatric intensive care unit,PICU)进行院际转运的急危重症患儿486例,其中2021年164例、2022年322例。以患儿转运病种的统计、转运中不良事件的发生率、原地抢救次数以及转运后入院治疗及转归情况进行记录与统计学分析,比较2021年与2022年院际安全转运情况,对其进行院际安全转运过程中的安全隐患与影响因素进行分析。结果2021年组与2022年组急危重症患儿的院际安全转运比较,两组患儿的转运病种差异无统计学意义(P>0.05);但转运过程不良事件发生比较,差异有统计学意义(P<0.05),2021年组与2022年组发生率分别为50.00%、7.76%,以2022年组较低。2021年组患儿原地抢救率为13.41%,而2022年组为3.42%(P<0.05),两组患儿在院际转运后转归情况均良好。结论急危重症患儿在院际安全转运过程中受外在因素和内在因素的影响,存在一定的安全隐患,但基本转运情况良好,可进一步通过安全风险控制提高院际转运的安全性。
基金supported by a grant from the Ministry of Science and Technology in China(2012BAI04B02).
文摘Background:With the unequal distribution of medical resources in developing countries,critially ill children need to be transferred to tertiary hospitals from primary hospitals with limited resources.Although a large number of critically ill children are transferred each day in China,the standard process of inter-hospital transport is not formulated.Methods:We retrospectively analyzed the data collected during transport.A total number of 9231 patients(≤14 years)who had been transferred to the Hunan Children's Hospital by a specialized team from primary hospitals from January 1,2009 to June 30,2012 were included in the study.Results:Nearly half of the critically ill children were neonates(48.72%)and two thirds of the children were suffering from respiratory,neurological and cardiac diseases.Multivariate adjusted odds ratios(OR)and 95%confidence intervals(CI)were calculated using unconditional logistic regression.Mobilization time in non-working hours was longer than the working hours(OR=1.186,95%CI=1.059-1.329).Our study showed that mobilization time for neonates was shorter than that for older children(OR=0.801,95%CI=0.692-0.928).The mobilization time of referral cases was shorter in areas within a radius of 50 km than in those within a radius of over 250 km(OR=0.427,95%CI=0.350-0.521).Referred patients in summer needed a significantly shorter mobilization time than in winter(OR=0.705,95%CI=0.616-0.806).Conclusion:Standardized processes and guidelines for inter-hospital transport would be essential to ensure effective transport of patients and reduce the mobilization activation time.
