急诊科留观患者非计划重返抢救室的现状及危险因素分析

doi:10.3761/j.issn.2096-7446.2023.07.015

摘要/Abstract

摘要： 目的分析急诊科留观患者非计划重返抢救室的病例特征,并探讨其危险因素。方法对武汉市某三级甲等综合医院急诊科2019年1月1日—2021年12月31日的2 735例从抢救室转留观室的患者病历资料进行回顾性分析,统计非计划重返抢救室率,比较非计划重返抢救室组和未重返抢救室组临床特征的差异,并应用二元Logistic回归分析非计划重返抢救室的危险因素。结果共有87例急诊科留观患者非计划重返抢救室,非计划重返抢救室率为3.2%。Logistic回归分析显示,年龄（OR=1.021）、分诊类别为不明原因腹痛（OR=2.916）、分诊类别为创伤（OR=0.226）与急诊科留观患者非计划重返抢救室相关（P<0.05）。结论年龄和不明原因腹痛是急诊科留观患者非计划重返抢救室的危险因素。建议对计划从急诊科抢救室转留观室的患者,构建特异性的风险评估方案,完善风险预警模型,降低急诊科留观患者非计划重返抢救室率。

关键词: 急诊室, 医院, 临床观察室, 抢救室, 非计划重返, 危险因素, 护理管理研究

Abstract: Objective To analyze the characteristics of emergency observation patients who unplanned return to the rescue room,and explore its risk factors. Methods A retrospective analysis was conducted on 2 735 patients in emergency observation room who were transferred from the rescue room of a tertiary Grade-A general hospital from January 1,2019 to December 31,2021. The rate of unplanned return to the rescue room was statistically analyzed,and the differences of clinical characteristics between the group of unplanned return to the rescue room and the non-return group were compared. The risk factors of unplanned return to the rescue room were analyzed by binary logistic regression. Results A total of 87 patients returned to the rescue room unplanned,the rate of unplanned return was 3.2%. Logistic regression analysis showed that age（OR=1.021）,unexplained abdominal pain （OR=2.916）,and trauma（OR=0.226)was associated with the unplanned return to the rescue room（P<0.05）. Conclusion Age and unexplained abdominal pain are risk factors for unplanned return to the rescue room. It is suggested to establish a standardized evaluation process for patients who are transferred to the observation room,especially elderly patients and patients with unexplained abdominal pain,so as to predict the risk of condition changes and reduce the incidence of unplanned return to the rescue room.

Key words: Emergency Service, Hospital, Clinical Observation Units, Emergency Treatment Room, Unplanned Return, Risk Factors, Nursing Administration Research

王芳, 郑丹莉, 黄素芳, 谢云丽, 冯梅, 谢拉, 杨英, 邓娟, 肖亚茹. 急诊科留观患者非计划重返抢救室的现状及危险因素分析[J]. 中华急危重症护理杂志, 2023, 4(7): 639-643.

WANG Fang, ZHENG Danli, HUANG Sufang, XIE Yunli, FENG Mei, XIE La, YANG Ying, DENG Juan, XIAO Yaru. Analysis on current situation and risk factors of unplanned return to the rescue room in patients under observation in emergency department[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(7): 639-643.

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