Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit
Introduction: Unplanned transfers from the General Ward to Critical Care Units occur due to a deterioration in the patient's clinical status. They are of great interest because of their negative impact, associated with longer hospital stays and higher mortality. Objectives: To report the freque...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2024
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/44675 |
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I10-R327-article-44675 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
patient transfer Argentina aged emergencies Argentina método retrospectivo traslado de pacientes emergencias adulto mayor Argentina método de projeção retrospectiva da população transferência de pacientes emergências idoso |
| spellingShingle |
patient transfer Argentina aged emergencies Argentina método retrospectivo traslado de pacientes emergencias adulto mayor Argentina método de projeção retrospectiva da população transferência de pacientes emergências idoso Murujosa, Anaclara Bronstein, Micaela Karina Martinez, Bernardo Grande Ratti, María Florencia Martingano, Ignacio Sberna, Federico Rueda, Victoria Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| topic_facet |
patient transfer Argentina aged emergencies Argentina método retrospectivo traslado de pacientes emergencias adulto mayor Argentina método de projeção retrospectiva da população transferência de pacientes emergências idoso |
| author |
Murujosa, Anaclara Bronstein, Micaela Karina Martinez, Bernardo Grande Ratti, María Florencia Martingano, Ignacio Sberna, Federico Rueda, Victoria |
| author_facet |
Murujosa, Anaclara Bronstein, Micaela Karina Martinez, Bernardo Grande Ratti, María Florencia Martingano, Ignacio Sberna, Federico Rueda, Victoria |
| author_sort |
Murujosa, Anaclara |
| title |
Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| title_short |
Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| title_full |
Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| title_fullStr |
Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| title_full_unstemmed |
Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| title_sort |
critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit |
| description |
Introduction: Unplanned transfers from the General Ward to Critical Care Units occur due to a deterioration in the patient's clinical status. They are of great interest because of their negative impact, associated with longer hospital stays and higher mortality.
Objectives: To report the frequency at which these transfers occur, characteristics of these patients and causes of the transfer. Identify shortcomings in the care process that may allow improvement strategies.
Methodology: cross-sectional study. Cases were considered those who, during the first 24 hours of hospitalization in the General Ward, required transfer to the ICU between January - December 2022 in a high-complexity hospital in Buenos Aires. Results: Of 8317 admissions, 124 were transferred to the ICU, with a rate of 14 per 1000 and an average of 70 years. The most frequent comorbidities were high blood pressure, heart failure, cancer and overweight-obesity. The main causes of hospitalization were respiratory and gastrointestinal symptoms. 67% had non-alarming results in the NEWS score prior to transfer to the ICU. The most frequent causes were respiratory failure, hemodynamic instability and requirement for monitoring. Average hospital stay was 10 days and in-hospital mortality was 26%.
Conclusions: Respiratory decompensation in elderly male patients was the most common cause of transfer to a Closed Unit. One of the shortcomings of the care process seems to be the NEWS score, where in 67% of cases it did not warn about the high requirement of patient monitoring. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2024 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/44675 |
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2025-02-05T22:05:36Z |
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2025-02-05T22:05:36Z |
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I10-R327-article-446752024-12-05T12:49:49Z Critical patients in general hospitalization wards: a descriptive analysis of factors inherent to the transfer to a closed unit: a descriptive analysis of factors inherent to the transfer to a closed unit El paciente crítico en sala de internación general: un análisis descriptivo sobre factores inherentes al pase a unidad cerrada O paciente crítico em enfermaria de internação geral: análise descritiva dos fatores inerentes à transferência para unidade fechada: análise descritiva dos fatores inerentes à transferência para unidade fechada Murujosa, Anaclara Bronstein, Micaela Karina Martinez, Bernardo Grande Ratti, María Florencia Martingano, Ignacio Sberna, Federico Rueda, Victoria patient transfer Argentina aged emergencies Argentina método retrospectivo traslado de pacientes emergencias adulto mayor Argentina método de projeção retrospectiva da população transferência de pacientes emergências idoso Introduction: Unplanned transfers from the General Ward to Critical Care Units occur due to a deterioration in the patient's clinical status. They are of great interest because of their negative impact, associated with longer hospital stays and higher mortality. Objectives: To report the frequency at which these transfers occur, characteristics of these patients and causes of the transfer. Identify shortcomings in the care process that may allow improvement strategies. Methodology: cross-sectional study. Cases were considered those who, during the first 24 hours of hospitalization in the General Ward, required transfer to the ICU between January - December 2022 in a high-complexity hospital in Buenos Aires. Results: Of 8317 admissions, 124 were transferred to the ICU, with a rate of 14 per 1000 and an average of 70 years. The most frequent comorbidities were high blood pressure, heart failure, cancer and overweight-obesity. The main causes of hospitalization were respiratory and gastrointestinal symptoms. 67% had non-alarming results in the NEWS score prior to transfer to the ICU. The most frequent causes were respiratory failure, hemodynamic instability and requirement for monitoring. Average hospital stay was 10 days and in-hospital mortality was 26%. Conclusions: Respiratory decompensation in elderly male patients was the most common cause of transfer to a Closed Unit. One of the shortcomings of the care process seems to be the NEWS score, where in 67% of cases it did not warn about the high requirement of patient monitoring. Introducción: Los traslados no programados, de Sala General a Unidades de Cuidados Críticos, se producen debido a un deterioro en el estado clínico del paciente. Son de gran interés debido a su impacto negativo, asociado con estadías hospitalarias más largas y mayor mortalidad. Objetivos: Reportar la frecuencia en la que ocurren estos traslados, las características de estos pacientes y las causas del pase. Identificar falencias del proceso asistencial que permitan generar estrategias de mejora. Metodología: estudio de corte transversal. Se consideraron casos quienes durante las primeras 24 horas de internación en Sala General requirieron traslado a UCI entre Enero - Diciembre 2022 en un hospital de alta complejidad en Buenos Aires. Resultados: De 8317 ingresos 124 fueron trasladados a UCI, con una tasa de 14 por 1000 y una media de 70 años. Las comorbilidades más frecuentes fueron hipertensión arterial, insuficiencia cardíaca, cáncer y sobrepeso-obesidad. Las principales causas de internación fueron cuadros respiratorios y gastrointestinales. Un 67% tuvieron resultados no alarmantes en el score NEWS previo al pase a UCI. Las causas más frecuentes fueron insuficiencia respiratoria, inestabilidad hemodinámica y requerimiento de monitoreo. La estadía hospitalaria media fue de 10 días y la mortalidad intrahospitalaria 26%. Conclusiones: Los descompensación respiratoria en pacientes añosos de sexo masculino fue la causa más común de pase a Unidad Cerrada.Una de las falencias del proceso asistencial pareciera ser el score NEWS, donde en un 67% de los casos no alertó sobre el alto requerimiento de monitoreo del paciente. Introdução: As transferências não programadas da Enfermaria Geral para Unidades de Cuidados Críticos ocorrem devido à deterioração do estado clínico do paciente. São de grande interesse devido ao seu impacto negativo, associado a internações hospitalares mais prolongadas e maior mortalidade. Objetivos: Relatar a frequência com que ocorrem essas transferências, as características desses pacientes e as causas da transferência. Identificar deficiências no processo de cuidado que permitam gerar estratégias de melhoria. Metodologia: estudo transversal. Foram considerados casos aqueles que, durante as primeiras 24 horas de internação na Enfermaria Geral, necessitaram de transferência para a UTI entre janeiro e dezembro de 2022 em um hospital de alta complexidade de Buenos Aires. Resultados: De 8.317 internações, 124 foram transferidas para UTI, com taxa de 14 por 1.000 e média de 70 anos. As comorbidades mais frequentes foram hipertensão arterial, insuficiência cardíaca, câncer e sobrepeso-obesidade. As principais causas de internação foram sintomas respiratórios e gastrointestinais. 67% tiveram resultados não alarmantes no escore NEWS antes da transferência para a UTI. As causas mais frequentes foram insuficiência respiratória, instabilidade hemodinâmica e necessidade de monitorização. A média de internação hospitalar foi de 10 dias e a mortalidade hospitalar foi de 26%. Conclusões: A descompensação respiratória em pacientes idosos do sexo masculino foi a causa mais comum de transferência para Unidade Fechada. Uma das deficiências do processo assistencial parece ser o escore NEWS, onde em 67% dos casos não alertou sobre a alta exigência de monitoramento do paciente. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2024-09-27 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/44675 10.31053/1853.0605.v81.n3.44675 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 81 No. 3 (2024); 503-519 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 81 Núm. 3 (2024); 503-519 Revista da Faculdade de Ciências Médicas de Córdoba; v. 81 n. 3 (2024); 503-519 1853-0605 0014-6722 10.31053/1853.0605.v81.n3 spa https://revistas.unc.edu.ar/index.php/med/article/view/44675/46592 https://revistas.unc.edu.ar/index.php/med/article/view/44675/46619 Derechos de autor 2024 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |