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題名:急診病患非計畫性轉入加護病房之存活分析
作者:謝育光
作者(外文):Yu Kuang Hsieh
校院名稱:長庚大學
系所名稱:企業管理研究所博士班
指導教授:王勝本
陳威志
學位類別:博士
出版日期:2016
主題關鍵詞:非計畫轉入加護病房Cox 比例危險模式APACHE II 分數昏迷指數(GCS)unplanned transfers to ICUCox proportional hazards modelAPACHE II scoreGlasgow Coma Scale (GCS)
原始連結:連回原系統網址new window
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非計畫性轉入加護病房的病患,不僅有較高的死亡率,且會耗用較多的醫療資源,但至今少有相關的研究,足以提供加護病房預測此類病患死亡之參考依據。本研究透過 Cox 比例危險模式,針對急診 24 小時內非計畫性轉入加護病房的病患進行存活分析;以台北市某區域醫院於 2008 年1 月初至 2013 年 12 月底共六年之中,由其急診 24 小時內非計畫性轉入其綜合加護病房之 1,462 位病患為樣本,資料為病患之診斷因子與人口變數。在整體樣本中,以男性的老年患者為大多數,而死亡病患群的年齡則高於存活病患組,並具有統計顯著。另外,關聯非外傷性腦受傷病患死亡風險的顯著因子為 APACHE II 分數,而影響腦外傷病患死亡風險的顯著因子則為 Glasgow 昏迷指數 (GCS) 與性別,且女性腦外傷患者的死亡風險是為男性的 1.75 倍。
Unplanned transfers to intensive care units (ICUs) not only have higher mortality rates, but also consume more medical resources, yet few publications could be found which report survival forecasts for unplanned transfers to ICUs. This study adopts the Cox proportional hazards model to investigate patient survival after unplanned transfer to intensive care from the emergency department within 24 hours of admission. The sampling period was for 6 years, from January 2008 to December 2013, and demographic and clinical variables were collected from 1,462 unplanned transfers to the comprehensive ICU of a regional hospital in Taipei, which occurred within 24 hours after emergency admission. Males and the elderly comprise the majority of the sampling data, which show that the post-ICU death group has a higher average age than that of the surviving group. Our research results indicate that the only risk factors with statistical significance are the APACHE II score for patients without head injuries and also both the gender and Glasgow Coma Scale (GCS) for the unplanned transfers who are suffering from traumatic brain injury, where females have 1.75 times the risk of their male counterparts.
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