原创力文档impact of delayed admission to intensive care units on mortality of critically ill patients a cohort study延迟的影响进入重症监护病房危重病人死亡率的队列研究.pdfVIP
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impact of delayed admission to intensive care units on mortality of critically ill patients a cohort study延迟的影响进入重症监护病房危重病人死亡率的队列研究
Cardoso et al. Critical Care 2011, 15:R28
/content/15/1/R28
RESEARCH Open Access
Impact of delayed admission to intensive care
units on mortality of critically ill patients: a cohort
study
*
Lucienne TQ Cardoso, Cintia MC Grion , Tiemi Matsuo, Elza HT Anami, Ivanil AM Kauss, Ludmila Seko,
Ana M Bonametti
Abstract
Introduction: When the number of patients who require intensive care is greater than the number of beds
available, intensive care unit (ICU) entry flow is obstructed. This phenomenon has been associated with higher
mortality rates in patients that are not admitted despite their need, and in patients that are admitted but are
waiting for a bed. The purpose of this study is to evaluate if a delay in ICU admission affects mortality for critically
ill patients.
Methods: A prospective cohort of adult patients admitted to the ICU of our institution between January and
December 2005 were analyzed. Patients for whom a bed was available were immediately admitted; when no bed
was available, patients waited for ICU admission. ICU admission was classified as either delayed or immediate.
Confounding variables examined were: age, sex, originating hospital ward, ICU diagnosis, co-morbidity, Acute
Physiology and Chronic Health Evaluation (APACHE) II score, therapeutic intervention, and Sequential Organ Failure
Assessment (SOFA) score. All patients were followed until hospital discharge.
Results: A total of 401 patients were evaluated; 125 (31.2%) patients were immediately admitted and 276 (68.8%)
patients had delayed admission. There was a significant increase in ICU mortality rates with a delay in ICU
admission (P = 0.002). The fraction of mortality risk attributable to ICU delay was 30% (95% confidence interval (CI):
11.2% to 44.8%). Each hour of waiting wa
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