465: UTILIZING AN ETHIOPIAN ICU REGISTRY TO IDENTIFY OPPORTUNITIES FOR QUALITY IMPROVEMENT
465: UTILIZING AN ETHIOPIAN ICU REGISTRY TO IDENTIFY OPPORTUNITIES FOR QUALITY IMPROVEMENT
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465：利用埃塞俄比亚 ICU 登记处来寻找质量改进的机会
DOI：
10.1097/01.ccm.0000808184.46355.b6
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发表时间：
2021
影响因子：
8.8
通讯作者：
Laytin A
中科院分区：
文献类型：
--
作者：
Laytin A
研究方法：我们使用Crit Care Asia开发的在线平台实施了一项新的、资源适当的ICU登记，以收集埃塞俄比亚阿迪斯两个三级ICU收治的重症患者的人口统计学、疾病模式、护理过程和临床结局的数据。临床数据由经过专门培训的数据员收集和输入。结果：2021年6月和7月，圣保罗医院和千禧医疗中心以及阿迪斯烧伤、急诊和创伤医院的ICU共收治83例患者。中位年龄为35岁（IQR 24-52），61%为男性。49%的患者在术后入院，68%的患者在急诊手术后入院。在ICU入院当天，77%的患者需要呼吸机支持，17%的患者需要血管活性药物支持。平均Apache II评分为24.1（SD 4.1）。截至7月31日，47%的患者从ICU活着转移，33%的患者在ICU死亡，20%的患者仍留在ICU。标化死亡率为1.02。平均住院时间（8.2天）是相似的幸存者和nonsurvivor.Conclusions：本报告表明，在埃塞俄比亚ICU使用重症监护亚洲平台收集监测数据的可行性，ICU登记的重要性，以了解ICU病例组合，护理过程和ICU的临床结局。这些ICU治疗危重疾病的负担很高。在这一初步分析中，观察到的高死亡率是由所治疗疾病的严重程度解释的。改善危重病的早期识别和分诊方案可能是提高ICU生存率的重要策略。
Methods: We implemented a novel, resource-appropriate ICU registry using an online platform developed by Crit Care Asia to collect data about the demographics, illness patterns, processes of care and clinical outcomes of critically ill patients admitted to two tertiary ICUs in Addis Ababa, Ethiopia. Clinical data were collected and inputted by specially trained data clerks. The first two months of patient data were extracted and analyzed descriptively.Results: In June and July, 2021, 83 patients were admitted to the ICUs at St. Paul Hospital and Millennium Medical Center and the Addis Ababa Burn, Emergency and Trauma Hospital. Median age was 35 years (IQR 24-52) and 61% were male. 49% of patients were admitted post-operatively, with 68% of those following emergency surgery. On the day of ICU admission 77% required ventilator support and 17% required vasoactive support. Mean Apache II score was 24.1 (SD 4.1). By July 31, 47% of patients were transferred from the ICU alive, 33% had died in the ICU and 20% remained in the ICU. Standardized mortality ratio was 1.02. Mean length of stay (8.2 days) was similar for survivors and non-survivors.Conclusions: This report demonstrates the feasibility of collecting surveillance data in Ethiopian ICUs using the Crit Care Asia platform, and the importance of ICU registries to understand ICU case-mix, processes of care and clinical outcomes in ICUs. These ICUs treat a high burden of critical illness. In this preliminary analysis, the high observed mortality rate is explained by the severity of illness being treated. Improving early recognition of critical illness and triage protocols may be important strategies to improve ICU survival.