RESUMO
Objective: This study aimed to determine the rate of readmission for trauma patients in ICUs, as well as the factors that predict this outcome. Methods: This retrospective cohort study was conducted at Emtiaz Hospital, a level I referral trauma center (Shiraz, Iran). It analyzed the ICU readmission rates among trauma patients over three years. The required data were extracted from the Iranian Intensive Care Registry (IICUR), which included patient demographics, injury severity, physiological parameters, and clinical outcomes. Statistical analysis was performed using SPSS version 25.0. Descriptive statistics and different statistical tests, such as T-tests, Mann-Whitney tests, Chi-square tests, and logistic binary regression test were utilized. Results: Among the 5273 patients discharged from the ICU during the study period, 195 (3.7%) were readmitted during the same hospitalization. Patients readmitted to the ICU had a significantly higher mean age (54.83±22.73 years) than those who were not readmitted (47.08 years, p<0.001). Lower Glasgow Coma Scale (GCS) scores at admission and discharge were associated with ICU readmission, implying that neurological status and readmission risk were correlated with each other. Furthermore, respiratory challenges were identified as the leading cause of unexpected readmission, including respiratory failure, hypoxic respiratory failure, respiratory distress, and respiratory infections such as pneumonia. Injury patterns analysis revealed a higher frequency of poly-trauma and head and neck injuries among patients readmitted to the ICU. Conclusion: This study underscored the importance of ICU readmission among trauma patients, with a high readmission rate during the same hospitalization. By developing comprehensive guidelines and optimizing discharge processes, healthcare providers could potentially mitigate ICU readmissions and associated complications, ultimately enhancing patient outcomes and resource utilization in trauma ICU settings. This research provided valuable insights to inform evidence-based practices and improve the quality of care delivery for trauma patients in intensive care settings.
RESUMO
Background: Electronic prescriptions represent a fundamental shift in service delivery, healthcare management, and associated costs, offering numerous advantages. However, akin to other electronic systems, they also present challenges. This study aimed to investigate patients' understanding of the challenges associated with electronic prescriptions in Iran. Methods: This study used a qualitative research design, utilizing individual and semi-structured interviews with patients referred to selected pharmacies across all 11 districts of Shiraz City. The data were analyzed using MAXQDA software (version 10), and descriptive statistics for demographic data were calculated using SPSS version 19. Results: The study revealed that the participants generally demonstrated a certain level of familiarity with electronic prescribing systems. However, it was evident that many were unaware of the potential implications of such technology for their relationships with healthcare providers. This underscores the urgent need for patient understanding in the context of the electronic prescription system. While patients were relatively familiar with the functionality of electronic prescribing systems, they lacked a comprehensive understanding of how using these systems could affect their interactions with healthcare providers. Conclusion: Patients are significant beneficiaries of the electronic prescribing system. By addressing their needs and concerns, they can develop a positive attitude toward this system. Their active engagement can pave the way for the system's ease of use, increase its acceptance, and ultimately enhance the quality of healthcare services.