摘要
目的探讨老年急危重症患者的急诊滞留相关因素。方法回顾分析本院急诊科年龄≥60岁的11 032例急危重症患者临床资料,对急诊滞留相关因素进行Logistic回归分析。结果老年急危重症患者平均滞留时间为461.90min;滞留时间≥8h为2919例(26.46%)。急诊滞留时间多因素Logistic回归分析显示就诊月份12~2月和3~5月OR值是9~11月1.812倍(1.583~2.075)和1.630倍(1.418~1.875),就诊时段0:00~7:59和8:00~15:59 OR值分别是16:00~24:00的0.496倍(0.431~0.572)和0.344倍(0.309~0.382)(P<0.05),重点病种、疾病诊断、静脉输液、气管插管、外科手术、介入治疗、溶栓治疗、临床转归和分诊科室均有统计学意义(P<0.05),而性别、年龄分层、机械通气和心肺复苏无统计学意义(P>0.05)。结论老年急危重症患者急诊滞留时间长,主要影响因素有就诊月份、就诊时段、重点病种、疾病诊断、静脉输液、气管插管、外科手术、介入治疗、溶栓治疗、临床转归和分诊科室,需要高度重视。
Objective To investigate the related factors of emergency detention in elderly patients with acute and critical ill.Methods The clinical data of 11 032 acute and critical patients aged≥60 years in the emergency department of our hospital were retrospectively analyzed,and the related factors of emergency detention were analyzed by logistic regression.Results The average detention time of elderly patients with acute and critical illness was 461.90 minutes;The detention time was≥8 hours in 2919 cases(26.46%).Multivariate logistic regression analysis showed that the OR values of patients admitted from December to February and from March to May were 1.812 times(1.583~2.075)and 1.630 times(1.418~1.875)compared to the OR value from September to November,respectively.The OR values of patients admitted during0:00~7:59 and8:00~15:59 were 0.496 times(0.431~0.572)and 0.344 times(0.309~0.382)compared to the OR value of 16:00~24:00,respectively(P< 0.05).There were significant differences in key diseases,diagnosis of disease,intravenous infusion,endotracheal intubation,surgery,interventional therapy,thrombolytic therapy,clinical outcome and triage departments(P<0.05),while no significant difference was found in gender,age stratification,mechanical ventilation and cardiopulmonary resuscitation(P>0.05).Conclusions The time of emergency detention in elderly patients with acute and critical ill prolonged.The main influencing factors included the month of visit,the period of visit,key diseases,diagnosis of disease,intravenous infusion,endotracheal intubation,surgery,interventional therapy,thrombolytic therapy,clinical outcome and triage departments,which needed to be paid more attention.
作者
杨志伟
赫留党
周世方
张芬
李长罗
丁宁
Yang Zhiwei;He Liudang;Zhou Shifang;Zhang fen;Li Changluo;Ding Ning(Emergency Department of Changsha Central Hospital,University of South China,Changsha,China)
基金
湖南省卫生计生委科研项目(项目编号:20201088)。
关键词
老年患者
急危重症
停留时间
相关因素
Elderly patients
Critical illness
Length of stay
Related factors
