Analysis of disease composition and outcome of patients in intensive care department of 3A hospitals: analysis of 3 249 cases in the department of Liaocheng People's Hospital from 2019 to 2021 / 中华危重病急救医学

ABSTRACT

Objective:To provide the basis and direction for the establishment of the database of severe patients by analyizing of the disease composition and outcome of patients in the department of critical care medicine of the 3A hospital.Methods:The clinical data of 3 249 patients admitted to the department of critical care medicine of Liaocheng People's Hospital from January 1, 2019 to December 31, 2021 were retrospectively analyzed, including gender, age, admission time, admission route, diagnosis, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score 24 hours after admission, outcome and other information.Results:The mean age of 3 249 patients was (61.99±18.29) years old, and the proportion of young and old patients aged 60-74 years accounted the largest (34.01%). There were more males (1 800 cases) than females (1 449 cases). The most patients were admitted in January (119 cases) and the least in March (75 cases). The top eight diseases in the department of critical care medicine were respiratory system diseases (21.88%), multiple injuries (12.65%), cardiovascular system diseases (11.48%), gastrointestinal surgery diseases (9.42%), pathological obstetrics (7.76%), digestive system diseases (7.63%), urinary system diseases (5.69%) and nervous system diseases (5.23%). Among 3 249 critically ill patients, 54.36% (1 766 cases) were transferred to the general ward for treatment after improvement, with APACHE Ⅱ score was 17.99±5.51. 15.91% (517 cases) returned to local hospital for further treatment after improvement, APACHE Ⅱ score was 22.48±6.57. 1.51% (49 cases) were transferred to superior hospitals, APACHE Ⅱ score was 21.71±5.18. 24.22% (787 cases) were discharged automatically, APACHE Ⅱ score was 25.64±5.45. 4.00% (130 cases) died in intensive care unit (ICU), APACHE Ⅱ score was 29.08±8.10. The APACHE Ⅱ score of patients who died in ICU was higher than that of patients who were transferred to another department, another hospital or discharged automatically after their condition improved, and the differences were statistically significant (all P < 0.001). Among 3 249 patients, a total of 1 265 patients were admitted to ICU for sepsis caused by aggravated infection, and 44.43% (562 cases) of the 1 265 patients improved to the general ward after treatment, with APACHE Ⅱ score was 18.99±5.46. 19.21% (243 cases) returned to local hospital after treatment with APACHE Ⅱ score was 22.79±6.74. 1.50% (19 cases) were transferred to superior hospitals for further treatment with APACHE Ⅱ score was 21.21±4.81. 31.54% (399 cases) were discharged automatically with APACHE Ⅱ score was 25.55±4.84; 3.32% (42 cases) died in ICU with APACHE Ⅱ score was 27.69±7.92. The APACHE Ⅱ score of patients who died in ICU was higher than that of patients who were transferred to another department, another hospital or discharged automatically after their condition improved, and the difference was statistically significant (all P < 0.001). Conclusions:Among the patient admitted to ICU 2019-2021 in Liaocheng People's Hospital, respiratory system diseases accounted for the first, multiple injuries accounted for the second place, followed by cardiovascular system diseases, gastrointestinal surgery diseases, pathological obstetrics, etc. Males and elderly patients aged 60-74 years have a higher proportion of severe cases. APACHE Ⅱ scores were associated with patients' prognosis.