What intensive care registries can teach us about outcomes.
What intensive care registries can teach us about outcomes.
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DOI：
10.1097/mcc.0000000000000865
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发表时间：
2021-10-01
影响因子：
3.3
通讯作者：
Haniffa R
中科院分区：
文献类型：
--
作者：
Beane A;Salluh JIF;Haniffa R
重症监护登记是衡量危重疾病后结果的代名词。他们能够提供纵向数据，以便对不同时间段内的结果进行基准比较，以及在区域和国家范围内的单位之间进行比较，这是评估护理质量和 ICU 绩效以及更好地了解病例组合的关键部分。本次审查旨在总结国际登记处目前报告的成果衡量指标的文献，描述当前在解释现有成果方面的优势和挑战，并强调登记册可以帮助改进现有和新成果衡量指标的实施和解释的领域。通过 ICU 登记处广泛报告的结果包括生存衡量、感兴趣的事件、患者报告的结果和资源利用衡量（包括成本）。尽管其采用率越来越高，但结果指标报告质量方面的挑战仍然存在。短期生存的衡量标准是可行的，但考虑到急慢性疾病管理背景下重症监护的不断变化的性质，那些需要更长时间随访的衡量标准越来越难以解释。此外，不同环境下患者群体和医疗机构的异质性使得国际基准的结果测量变得极其复杂，需要在其定义和实施方面取得重大进展，以支持那些寻求改善患者护理的人。数字登记可以通过报告标准化和数据协调来帮助克服当前在实施和解释 ICU 结果数据方面的一些挑战。此外，ICU 登记可以有助于提供数据反馈，作为改善以患者为中心的结果和服务结果的一部分；特别是资源利用率和效率。
Critical care registries are synonymous with measurement of outcomes following critical illness. Their ability to provide longitudinal data to enable benchmarking of outcomes for comparison within units over time, and between units, both regionally and nationally is a key part of the evaluation of quality of care and ICU performance as well as a better understanding of case-mix. This review aims to summarise literature on outcome measures currently being reported in registries internationally, describe the current strengths and challenges with interpreting existing outcomes and highlight areas where registries may help improve implementation and interpretation of both existing and new outcome measures. Outcomes being widely reported through ICU registries include measures of survival, events of interest, patient reported outcomes and measures of resource utilisation (including cost). Despite its increasing adoption, challenges with quality of reporting of outcomes measures remain. Measures of short-term survival are feasible, but those requiring longer follow-ups are increasingly difficult to interpret given the evolving nature of critical care in the context of acute and chronic disease management. Furthermore, heterogeneity in patient populations and in healthcare organisations in different settings makes use of outcome measures for international benchmarking at best complex, requiring substantial advances in their definitions and implementation to support those seeking to improve patient care. Digital registries could help overcome some of the current challenges with implementing and interpreting ICU outcome data through standardisation of reporting and harmonisation of data. In addition, ICU registries could be instrumental in enabling data for feedback as part of improvement in both patient centred outcomes and in service outcomes; notably resource utilisation and efficiency.
影响因子：
2.2
作者：
Harrison DA;Lone NI;Haddow C;MacGillivray M;Khan A;Cook B;Rowan KM
通讯作者：
Rowan KM