CAJ | 학술논문

目的探讨创伤急救体系相关因素对患者住ICU时间的影响,并找出导致住ICU时间延长的独立危险因素. 方法回顾性分析2009年浙江省5所三级医院急诊室首诊并入住ICU的1361例创伤患者,通过Logistic回归模型筛选出导致患者住ICU时间延长(≥15 d)的独立危险因素. 结果共有192例住ICU时间≥15d,占14.1％.单因素分析结果提示,ISS≥16分、GCS≤7分、钝性伤、院前急救、急诊室滞留时间≥4 h、机械通气和中心静脉压监测与创伤患者住ICU时间延长相关.多因素Logistic回归分析结果提示,院前急救是创伤患者住ICU时间≥15 d的保护因素,机械通气、急诊室滞留时间≥4 h、ISS≥16分是创伤患者住ICU时间≥15 d的独立危险因素. 结论院前急救以及ICU救治对患者住ICU时间有着重要的影响.缩短患者在急诊室的滞留时间有助于减少患者住ICU时间.
목적 탐토창상급구체계상관인소대환자주ICU시간적영향,병조출도치주ICU시간연장적독립위험인소. 방법 회고성분석2009년절강성5소삼급의원급진실수진병입주ICU적1361례창상환자,통과Logistic회귀모형사선출도치환자주ICU시간연장(≥15 d)적독립위험인소. 결과 공유192례주ICU시간≥15d,점14.1％.단인소분석결과제시,ISS≥16분、GCS≤7분、둔성상、원전급구、급진실체류시간≥4 h、궤계통기화중심정맥압감측여창상환자주ICU시간연장상관.다인소Logistic회귀분석결과제시,원전급구시창상환자주ICU시간≥15 d적보호인소,궤계통기、급진실체류시간≥4 h、ISS≥16분시창상환자주ICU시간≥15 d적독립위험인소. 결론 원전급구이급ICU구치대환자주ICU시간유착중요적영향.축단환자재급진실적체류시간유조우감소환자주ICU시간.
Objective To investigate the effect of factors correlated with trauma emergency care system on the length of ICU stay and figure out independent risk factors of prolonged ICU stay. Methods A total of 1 361 trauma patients admitted to the ICU of five tertiary hospitals in Zhejiang province in 2009 were retrospectively studied.Demographic data,time of ICU stay and variables related to trauma care were collected.Logistic regression was performed to determine the independent risk factors of prolonged ICU stay ( ≥ 15 days). Results Overall,192 trauma patients ( 14.1％ ) had a prolonged ICU stay ( ≥15 days).Single factor analysis indicated that ISS≥ 16 points,GCS≤7 points,blunt trauma,prehospital emergency care,length of emergency department stay ≥4 hours,mechanical ventilation and central venous pressure monitoring were associated with the prolonged ICU stay.Multivariate analysis showed that pre-hospital emergency care was a protective factor for the prolonged ICU stay( ≥ 15 days) and that mechanical ventilation,length of emergency room stay≥4 hours and ISS≥ 16 points were the independent risk factors for the prolonged ICU stay ( ≥ 15 days). Conclusions Pre-hospital emergency care and ICU care show significant influence on the length of ICU stay.Furthermore,shortened length of emergency department stay is also contributive to reduced length of ICU stay.