성인 중환자실에 입실한 환자의 중환자실 체류기간에 영향을 미치는 요인 탐색
Factors Influencing Intensive Care Unit Length of Stay of Patients with Critical Illness
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연구목적: 본 연구는 성인 통합 중환자실에 입실 환자를 대상으로 중환자실 체류기간에 영향을 미치는 요인을 인구사회학적, 질병관련 특성을 중심으로 파악하여 효율적인 중환자 간호 중재 개발의 기초적 자료를 제공하기 위하여 실시하였다. 연구방법: 서울특별시에 소재한 일 종합병원의 성인 통합 중환자실에 입실한 환자 최종 270명을 분석한 후향적 조사연구이다. 연구결과: 분석대상 270명 환자 중 중환자실 체류기간이 5일 이상 그룹이 116명(43%)이었으며, 중환자실 체류기간은 FCI score (r=0.33, p<.001), APACHE Ⅱ(r=0.19, p=.001)와 통계적으로 유의한 상관관계가 있는 것으로 나타났다.로지스틱 회귀분석 결과 중환자실 체류기간의 영향요인은 일반적 특성을 통제한 상태에서 대상자의 중환자실 입실경로(p=0.013), FCI score(p<0.001), APACHE Ⅱ(p=0.012)로 나타났다. 결론: 중환자실 입실시 응급실 경유나 중증도가 높은 환자의 경우, 입실 초기 보다 집중적인 환자간호를 통해 환자의 체류기간을 줄이도록 하는 다양한 중재개발이 모색되어야 하겠다.
Abstract
Purpose: The aim of this study was to identify the factors influencing ICU (intensive care units) length of stay of adult patients with critical illness. Methods: This study was adopted descriptive design. 270 patients who were admitted to ICU in general hospital, Seoul were analyzed. Results: A total of 270 patients, 116 (43%) patients had stayed more than 5 days. The length of stay of intensive care unit was significant positive correlation with the FCI(Functional Comobidity Index) score(r=0.33, p<.001) and APACHE(Aacute Physiology and Chronic Health Evlauaion) Ⅱ(r=0.19, p=.001). In multiple logistic regression, the predictors of ICU length of stay were admission route (p=0.013), FCI score (p<0.001), APACHE Ⅱ(p=0.012). Conclusions: Heatlh care providers in ICU should be aware that patients who admit to emergency departments and have higher disease severity are more considered to reduce their ICU length of stays.
참고문헌 (28)
- R. S. Stephens, "Postoperative Critical Care of the Adult Cardiac Surgical Patient. PartⅠ:Routine Postoperative Care", Crit Care Med, 43(7), pp.1477~1497 (2015)
- M. A. Pisani, "Considerations in caring for the critically ill older patient", J Intensive Care Med, 24(2), pp.83~95 (2009)
- M. Yantori, "Feasibility of the fast-track recovery program after cardiac surgery in Japan", General Thoracic Cardiovascular Surgery, 55(11), pp.445~449 (2007)
- K. Salhiyyah, "A clinical and economic evaluation of fast-track recovery after cardiac surgery", The Heart SurgeryForum, 14(6), pp.330~334 (2011)
- K. koukourikos, "Muscle atrophy in intensive care unit patients", Acta informatica Medica, 22(6), pp.406~410 (2014)
- D. L. Groll, "The development of a comorbidity index with physical function as the outcome", J Clin Epidemiol, 58(6), pp.595~602 (2005)
- H. Kimberley, "Predicting Physical Function and Health Related Quality of Life Following Intensive care", Int J Phys Med Rehabil, 2(1) (2014)
- P. J. Huggan, "Measures of acute physiology, comorbidity and functional status to differentiate illness severity and length of stay among acute general medical admissions: a prospective cohort study", Intern Med J, 45(7), pp.732~740 (2015)
- A. Almashraf, "Systematic review of factors influencing length of stay in ICU after adult cardiac surgery", BMC Health Serv Res, 29(16), pp.318~ (2016)
- J. Venker, "Long-term outcome after 60 days of intensive care", Anaesthesia, 60(6), pp.541~546 (2005)
- A. J. Campbell, "Predicting death and readmission after intensive care discharge", Br J Anaesth, 100(5), pp.656~662 (2008)
- M. M. Berger, "Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ)scoring in a surgical intensive care unit", Crit Care Med, 20(12), pp.1681~1687 (1992)
- S. Hariharan, "Characteristics of Patients Requiring Prolonged Length of Stay in a Surgical Intensive Care Unit Barbados", West Indian Med J, 55(1), pp.25~29 (2006)
- A. B. Bohmer, "Factors influencing lengths of stay in the intensive care unit for surviving trauma patients: a retrospective analysis of 30,157 cases", Crit Care, 18(4), pp.143~ (2014)
- 김유정, "중환자실 환자의 비계획적 재입실 위험 요인", 임상간호연구, 19(2), pp.265~274 (2013), 병원간호사회
- 김수경, "중환자실 퇴원환자의 집중치료 후 증후군과 삶의 질", 중환자간호학회지, 9(1), pp.1~14 (2016), 한국중환자간호학회
- C. E. Battle, "Long Term Health-Related Quality of life in Survivors of Sepsis in South West Wales: An Epidemiological Study", PLoS One, 30(9(12)) (2014)
- D. L. Groll, "Assessment of Long-Term Physical Function in Acute Respiratory Distress syndrome(ARDS) Patients", Am J Phys Med Rehabil, 85(7), pp.574~581 (2016)
- C. G. Levine, "Functional Comorbidity Index in Sleep Apnea", Otolaryngol Head Neck Surg, 150(3), pp.494~500 (2014)
- A. Ferrer, "Multimorbidity as speccific disease combination, an important predictor factor for mortality in octogenarians: the Octabaix study", Clin Interv Aging, 27(12), pp.223~231 (2017)
- L. M. Perez, "Rehabilitation Profiles of Older Adult Stroke Survivors Admitted to Intermediate Care: A Multi Centre Study", PLos One, 9(11(11)) (2016)
- S. Ozbilgin, "Morbidity and Mortality predictivity of nutritional assessment tools in the postoperative care unit", Medicine, 9(40), pp.e5038~ (2016)
- C. Limsuwa, "Nugent, Factors Influencing the Length of Hospital Stay in Patients With Acute Exacerbation of Chronic Obstruction Pulmonary Disease Admitted to Intensive Care Units", Qual Manag Health Care, 23(2), pp.86~93 (2014)
- S. A. Naved, "APACHE Ⅱ score correlation with mortality and length of stay in an intensive care unit", J Coll Physicians Surg Pak, 21(1), pp.4~8 (2011)
- 조광원, "외상 중환자의 예후 예측을 위한 TRISS, APACHE II, SAPS II의 비교", 대한응급의학회지, 13(4), pp.434~443 (2002), 대한응급의학회
- Y. Sakr, "Comparison of the performance of SAPS Ⅱ, SAPS 3, APACHE Ⅱ, and their customized prognostic models in a surgical intensive care unit", Br J Anaesth, 101(6), pp.798~803 (2008)
- M. Suistomaa, "Customized prediction models based on APACHE Ⅱ and SAPS Ⅱ sores in patients with prolonged length of stay in the ICU", Intensive Care Med, 28(4), pp.479~485 (2002)
- F. Cacciatore, "Determinants of prolonged intensive care unit stay after cardiac surgery in the elderly", Aging Clin Exp Res, 24(6), pp.627~634 (2012)