从重症监护室出院当天的护理工作量与再入院有关

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Abstract

Purpose

To verify whether there is an association between the Nursing Activities Score (NAS) on the day of discharge from the intensive care unit and readmission..

Materials and methods

A retrospective cohort study of all patients admitted to the intensive care unit of Hospital Ernesto Dornelles, Porto Alegre, Brazil, who were discharged to the ward from October 2018 to December 2019. We collected demographic and clinical variables of the patients and the Nursing Activities Scoreon the day of discharge. Patients were followed up until the day of hospital discharge or death.

Results

We included 1045 patients in the final sample. One hundred eighty-eight (18.0%) patients were readmitted, in addition there were two (0.2%) unexpected deaths that occurred in the ward. The median NAS was 59.9 (50.9–67.3), which was higher in the bivariate analysis in patients who were readmitted (64.0, 55.7–71.4) than in patients who were not readmitted (58.7, 49.7–66.1) (p < 0.001). Patients with a Nursing Activities Score  ≥ 60.0 and < 60.0 had rates of readmission of 23.4% and 12.7%, respectively (p < 0.001). After multivariable adjustment, the Nursing Activities Score at discharge maintained an association with readmission. In addition, in the Cox regression, the Nursing Activities Score as a dichotomous variable was independently associated with readmission (adjusted HR 1.560; CI 1.146–2.125; p = 0.005).

Conclusions

We found that the nursing workload, assessed by the Nursing Activities Score at the time of discharge from the intensive care unit, was associated with risk of readmission..

摘要翻译（仅供参考）

目的

验证从重症监护室出院当天的护理活动评分（NAS）与再入院之间是否存在关联。

材料和方法

对巴西阿雷格里港Ernesto Dornelles医院重症监护室收治的所有患者进行回顾性队列研究，这些患者在2018年10月至2019年12月期间出院到病房。我们收集了患者的人口学和临床变量以及出院当天的护理活动评分。对患者进行随访，直到出院日或死亡。

结果

我们在最终样本中纳入了1045名患者。有188名（18.0%）患者再次入院，此外，有2名（0.2%）患者在病房内意外死亡。NAS的中位数为59.9（50.9-67.3），在双变量分析中，再次入院的患者（64.0，55.7-71.4）高于未再次入院的患者（58.7，49.7-66.1）（P <0.001）。护理活动评分≥60.0和<60.0的患者的再入院率分别为23.4%和12.7%（p <0.001）。经多变量调整后，出院时的护理活动评分与再入院保持关联。此外，在Cox回归中，护理活动评分作为一个二分变量与再入院独立相关（调整后的HR为1.560；CI为1.146-2.125；p = 0.005）。

结论

我们发现，从重症监护室出院时，通过护理活动评分评估的护理工作量与再入院的风险有关。

THE

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