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首页> 外文期刊>Hawai i Journal of Medicine & Public Health: A journal of Asia Pacific medicine & public health >What's the Plan? Needing Assistance with Plan of Care Is Associated with In-Hospital Death for ICU Patients Referred for Palliative Care Consultation
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What's the Plan? Needing Assistance with Plan of Care Is Associated with In-Hospital Death for ICU Patients Referred for Palliative Care Consultation

机译：有什么计划？对于需要姑息治疗咨询的ICU患者，院内死亡需要与护理计划相关的协助

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摘要

To inform earlier identification of intensive care unit (ICU) patients needing palliative care, we examined factors associated with in-hospital death among ICU patients (N=260) receiving palliative care consultations at a 542-bed tertiary care hospital (2005–2009). High pre-consultation length of stay (LOS, ≥7 days) (adjusted odds ratio (aOR)=5.0, 95% confidence interval (95% CI)=2.5–9.9, P<.01) and consultations for assistance with plan of care (aOR=11.6, 95% CI=5.6–23.9, P<.01) were independently associated with in-hospital death. Patients with both consultation for plan of care and high pre-consult LOS had the highest odds of in-hospital death (aOR=36.3, 95% CI=14.9–88.5, P<.001), followed by patients with consultation for plan of care and shorter pre-consult LOS (aOR=9.8, 95% CI=4.3–22.1, P<.001), and patients with long pre-consult LOS but no consultation for plan of care (aOR=4.7, 95% CI=1.8–12.4, P=.002). Our findings suggest that ICU patients who require assistance with plan of care need to be identified early to optimize end-of-life care and avoid in-hospital death.
机译：为了更早地识别需要姑息治疗的重症监护病房（ICU）患者，我们检查了在542张病床的三级护理医院接受姑息治疗的ICU患者（N = 260）的院内死亡相关因素（2005-2009年） 。咨询前的长期住院时间（LOS，≥7天）（校正比值比（aOR）= 5.0，95％置信区间（95％CI）= 2.5-9.9，P <.01），并咨询有关计划的帮助护理（aOR = 11.6，95％CI = 5.6-23.9，P <.01）与院内死亡独立相关。既有护理计划咨询又有高咨询前LOS的患者院内死亡的几率最高（aOR = 36.3，95％CI = 14.9-88.5，P <.001），其次是有护理计划咨询的患者。护理和较短的咨询前LOS（aOR = 9.8，95％CI = 4.3-22.1，P <.001），以及咨询前LOS长但未制定护理计划的患者（aOR = 4.7，95％CI = 1.8–12.4，P = .002）。我们的发现表明，需要尽早确定需要护理计划帮助的ICU患者，以优化临终护理并避免住院死亡。

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