중환자실 환자의 비계획적 재입실 위험 요인
Risk Factors of Unplanned Readmission to Intensive Care Unit
0
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to determine the risk factors contributed to unplanned readmission to intensive care unit (ICU) and to investigate the prediction model of unplanned readmission. Methods: We retrospectively reviewed the electronic medical records which included the data of 3,903 patients who had discharged from ICUs in a university hospital in Seoul from January 2011 to April 2012. Results: The unplanned readmission rate was 4.8% (n=186). The nine variables were significantly different between the unplanned readmission and no readmission groups: age, clinical department, length of stay at 1st ICU, operation, use of ventilator during 24 hours a day, APACHE II score at ICU admission and discharge, direct nursing care hours and Glasgow coma scale total score at 1st ICU discharge. The clinical department, length of stay at 1st ICU,operation and APACHE II score at ICU admission were the significant predictors of unplanned ICU readmission. The predictive model's area under the curve was .802 (p<.001). Conclusion: We identified the risk factors and the prediction model associated with unplanned ICU readmission. Better patient assessment tools and knowledge about risk factors could contribute to reduce unplanned ICU readmission rate and mortality.
Abstract
Purpose: The aim of this study was to determine the risk factors contributed to unplanned readmission to intensive care unit (ICU) and to investigate the prediction model of unplanned readmission. Methods: We retrospectively reviewed the electronic medical records which included the data of 3,903 patients who had discharged from ICUs in a university hospital in Seoul from January 2011 to April 2012. Results: The unplanned readmission rate was 4.8% (n=186). The nine variables were significantly different between the unplanned readmission and no readmission groups: age, clinical department, length of stay at 1st ICU, operation, use of ventilator during 24 hours a day, APACHE II score at ICU admission and discharge, direct nursing care hours and Glasgow coma scale total score at 1st ICU discharge. The clinical department, length of stay at 1st ICU,operation and APACHE II score at ICU admission were the significant predictors of unplanned ICU readmission. The predictive model's area under the curve was .802 (p<.001). Conclusion: We identified the risk factors and the prediction model associated with unplanned ICU readmission. Better patient assessment tools and knowledge about risk factors could contribute to reduce unplanned ICU readmission rate and mortality.
참고문헌 (24)
- Alban, R. F., "Readmission to surgical intensive care increases severity-adjusted patient mortality", Trauma, 60(5), pp.1027~1031 (2006)
- Campbell, A. J., "Predicting death and readmission after intensive care discharge", British Journal of Anaesthesia, 100(5), pp.656~662 (2008)
- Chaboyer, W., "The intensive care unit liaison nurse : Towards a clear role description", Intensive and Critical Care Nursing, 20(2), pp.77~86 (2004)
- Chen, L. M., "Patients readmitted to the intensive care unit during the same hospitalization : Clinical features and outcomes", Critical Care Medicine, 26(11), pp.1834~1841 (1998)
- Choi, E. Y., "A study on the related factors of readmission to intensive care unit", 석사, pp.2006
- Cohen, J., "Statistical power analysis for the behavioral sciences" (1988), Lawrence Erlbaum Associates
- Cooper, G. S., "Are readmissions to the intensive care unit a useful measure of hospital performance?", Medical Care, 37(4), pp.399~408 (1999)
- De Cubber, M., "The ICU discharge score to evaluate the risk of readmission", Chest, 128(4), pp.349S~ (2005)
- Elliott, M., "Readmission to intensive care : A review of the literature", Australian Critical Care, 19(3), pp.96~104 (2006)
- Gajic, O., "The stability and workload index for transfer score predicts unplanned intensive care unit patient readmission : Initial development and validation", Critical Care Medicine, 36(3), pp.676~682 (2008)
- 한동우, "중환자실 재입실 환자의 임상적 고찰 및 예후 인자", Korean Journal of Anesthesiology, 44(1), pp.78~83 (2003), 대한마취통증의학회
- 신증수, "중환자실 재입실 환자의 임상 예후", Korean Journal of Anesthesiology, 47(3), pp.385~388 (2004), 대한마취통증의학회
- Ho, K. M., "Bayesian approach to predict hospital mortality of intensive care readmissions during the same hospitalisation", Anaesthesia and Intensive Care, 36(1), pp.38~45 (2008)
- "Acute care indicators" (2010)[URL]
- Jang, Y. S., "Development of admission and discharge criteria in intensive care unit", 석사, pp.2000
- Kim, N. M., "An exploratory study on the ICU readmission and its related factors in adults", Nursing Science, 20(1), pp.23~32 (2008)
- The survey on nurse staffing status of hospital. 2006 Annual report, "Korean Hospital Nurses Association", Korean Hospital Nurses Association, ~ (2007)
- Lee, H. F., "Revised acute physiology and chronic health evaluation score as a predictor of neurosurgery intensive care unit readmission : A case-controlled study", Journal of Critical Care, 25(2), pp.294~299 (2010)
- Lee, J. Y., "Development of a prediction model for ICU readmission as a quality indicator", 석사, pp.2008
- Linton, S., "The development of a clinical markers score to predict readmission to paediatric intensive care", Intensive and Critical Care Nursing, 25(6), pp.283~293 (2009)
- Metnitz, P. G. H., "Critical ill patients readmitted to intensive care units-lessons to learn?", Intensive Care Medicine, 29(2), pp.241~248 (2003)
- Rosenberg, A. L., "Patients readmitted to ICUs: A systematic review of risk factors and outcomes", Chest, 118(2), pp.492~502 (2000)
- Russell, S., "Reducing readmissions to the intensive care unit", Heart and Lung, 28(5), pp.365~372 (1999)
- Song, D. H., "Unplanned readmission to intensive care unit during the same hospitalization at a teaching hospital", Journal of Korean Society of Quality Assurance in Health Care, 10(1), pp.28~41 (2003)