Intensive Care Unit and Acute Care Unit Length of Stay After Congenital Heart Surgery.
Intensive Care Unit and Acute Care Unit Length of Stay After Congenital Heart Surgery.
复制标题
先天性心脏手术后重症监护病房和急性护理单位住院时间。
DOI：
10.1016/j.athoracsur.2020.01.033
复制
发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Madsen N
中科院分区：
文献类型：
--
作者：
Hart SA;Tanel RE;Kipps AK;Hoerst AK;Graupe MA;Cassidy SC;Hlavacek AM;Clabby ML;Bush LB;Zhang W;Banerjee MM;Pasquali SK;Gaies M;Madsen N
术后住院时间（LOS）是一项重要的质量指标，已知先天性心脏病手术后各医院的住院时间差异很大。这种变异性是否由与重症监护室（ICU）或急性监护室（ACU）相关的因素解释尚不清楚。我们评估了ICU和ACU LOS之间的关系以及ACU特征对术后LOS的影响。纳入了儿科心脏重症监护联盟（PC 4）登记研究（2014年8月至2018年2月）中的先天性心脏病手术住院。通过调整各医院病例组合的差异，开发了ICU、ACU和术后LOS的模型。参与儿科急性护理心脏病学协作（PAC 3）的PC 4医院也对ACU组织因素和实践模式进行了调查。总体而言，包括27家医院的19，674例住院治疗。ICU和ACU的LOS差异有统计学意义。术后LOS似乎与ICU LOS最密切相关; 75%（6/8）的术后LOS短于预期的医院也短于预期的ICU LOS。未观察到术后和ACU LOS之间的明确关系。根据PAC 3调查，ACU能够提供更高紧急度护理的医院更可能有更短的术后LOS（P <0.01）。对于先天性心脏病手术后达到比预期更短的术后LOS的医院，ICU LOS似乎是主要驱动因素。ACU中更高的紧急度资源可能是促进从ICU早期转移的重要因素。这些数据是为减少术后LOS提供质量改进措施的关键。
Postoperative length of stay (LOS) is an important quality metric and is known to vary widely across hospitals after congenital heart surgery. Whether this variability is explained by factors associated with the intensive care unit (ICU) or acute care unit (ACU) remains unclear. We evaluated the relationship between ICU and ACU LOS and the impact of ACU characteristics on postoperative LOS. Hospitalizations for congenital heart surgery within the Pediatric Cardiac Critical Care Consortium (PC4) registry (August 2014 to February 2018) were included. Models were developed for ICU, ACU, and postoperative LOS by adjusting for differences in case-mix across hospitals. PC4 hospitals participating in the Pediatric Acute Care Cardiology Collaborative (PAC3) were also surveyed on ACU organizational factors and practice patterns. Overall, 19,674 hospitalizations across 27 hospitals were included. There was significant variation in ICU and ACU LOS. Postperative LOS appeared to be most closely related to ICU LOS; 75% (6 of 8) of hospitals with shorter than expected postoperative LOS also had shorter than expected ICU LOS. A clear relationship between postoperative and ACU LOS was not observed. Hospitals with an ACU able to provide higher-acuity care as indexed according to the PAC3 survey were more likely to have shorter postoperative LOS (P < .01). For hospitals that achieve shorter than expected postoperative LOS after congenital heart surgery, ICU LOS appears to be the primary driver. Higher-acuity resources in the ACU may be an important factor facilitating earlier transfer from the ICU. These data are key to informing quality improvement initiatives geared toward reducing postoperative LOS.
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影响因子：
0.3
作者：
Hoerst, Amanda;Bakar, Adnan;Tanel, Ronn E.
通讯作者：
Tanel, Ronn E.
DOI：
10.1097/pcc.0000000000000918
发表时间：
2016-10
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Mahle WT;Nicolson SC;Hollenbeck-Pringle D;Gaies MG;Witte MK;Lee EK;Goldsworthy M;Stark PC;Burns KM;Scheurer MA;Cooper DS;Thiagarajan R;Sivarajan VB;Colan SD;Schamberger MS;Shekerdemian LS;Pediatric Heart Network Investigators
通讯作者：
Pediatric Heart Network Investigators
影响因子：
4.6
作者：
Jacobs, Jeffrey Phillip;O'Brien, Sean M.;Mavroudis, Constantine
通讯作者：
Mavroudis, Constantine
影响因子：
1
作者：
Gaies, Michael;Anderson, Jeffrey;Pearson, Gail
通讯作者：
Pearson, Gail
影响因子：
1
作者：
Franklin, Rodney C G;Beland, Marie J;Jacobs, Jeffrey P
通讯作者：
Jacobs, Jeffrey P