کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2764654 1150934 2014 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Outcome of hypotensive ward patients who re-deteriorate after initial stabilization by the Medical Emergency Team
ترجمه فارسی عنوان
نتیجه بیماران تحت درمان با کمخونی که پس از تثبیت اولیه توسط گروه اورژانس پزشکی بدست می آید یک ؟؟
کلمات کلیدی
تیم اورژانس پزشکی، فشار خون، بیماران بخش مرگ و میر انتقال واحد مراقبت های ویژه
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

PurposeWe evaluated the outcome of hypotensive ward patients who re-deteriorated after initial stabilization by the Medical Emergency Team (MET) in our hospital, due to limited data in this regard.MethodsOne thousand one hundred seventy-nine MET calls in 32184 ward patients from January 2009 to August 2011 were evaluated. Four hundred ten hypotensive patients met study criteria and were divided into: (1)“Immediate Transfers (IT), n = 136”:admitted by MET to intensive care unit (ICU) immediately; (2)“Re-deteriorated Transfers (RDT) n = 72”:initially stabilized and signed off by MET, but later re-deteriorated within 48-hours and admitted to ICU; (3)“Ward Patients (WP) n = 202”: remained stable on ward after treatment.ResultsThe RDT and IT had similar APACHE II scores (20.2 ± 5.1 vs. 19.8 ± 4.8; P= .57], but RDT showed hemodynamic stabilization with initial MET resuscitation. Patients who re-deteriorated were younger, took longer for eventual ICU transfer, had higher initial lactic acid and delayed normalization as compared to IT (P < .04). The re-deterioration predominantly occurred within 8-hours of MET evaluation. RDT had higher 28-day mortality than IT and WP; 42% vs. 27% vs. 7% respectively (P < .03). RDT also had a higher rate of endotracheal intubation and worse ICU mortality (P < .01).ConclusionHypotensive ward patients who re-deteriorate after initial stabilization have higher mortality. METs should consider implementing at least an 8-hour follow-up in patients who are deemed stable to remain on the wards after hypotensive episodes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Critical Care - Volume 29, Issue 1, February 2014, Pages 54–59
نویسندگان
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