집중치료실 퇴실환자의 비계획성 재입실 예측 인자를 규명하기 위한 사례대조군 연구

초록

Purpose : This study was performed to identify the influencing factors of unplanned intensive care unit (ICU) readmission. Methods : The study adopted a Rretrospective case control cohort design. Data were collected from the electronic medical records of 844 patients who had been discharged from the ICUs of a university hospital in Incheon from June 2014 to December 2014. Results : The study found the unplanned ICU readmission rate was to be 6.4%(n=54). From the univariate analysis revealed that, major symptoms at 1st ICU admission, severity at 1st ICU admission (CPSCS and APACHEⅡ), duration of applying ventilator application during 1st ICU admission, severity at 1st discharge from ICU (CPSCS, APACHEⅡ, and GCS), and application of FiO2 with oxygen therapy, implementation of sputum expectoration methods, and length of stay of ICU at 1st ICU discharge were appeared to be significant; further, decision tree model analysis revealed that while only 4 variables (sputum expectoration methods, length of stay of ICU, FiO2 with oxygen therapy at 1st ICU discharge, and major symptoms at 1st ICU admission) were shown to be significant. Conclusions : Since sputum expectoration method was the most important factor to predictor of unplanned ICU readmission, a assessment tool for the patients’ capability of sputum expectoration needs to should be developed and implemented, and standardized ICU discharge criteria, including the factors identified from the by empirical evidences, might should be developed to decrease the unplanned ICU readmission rate.

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