武汉市麻醉质控中心医师对非计划转入ICU相关因素认知调查分析

张杨; 彭晓红; 张佩茹; 余晖

doi:10.14188/j.1671-8852.2024.0815

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武汉市麻醉质控中心医师对非计划转入ICU相关因素认知调查分析

临床医学研究 | 更新时间：2026-11-05

- 武汉市麻醉质控中心医师对非计划转入ICU相关因素认知调查分析
- Investigation on the perception of Wuhan Anesthesia Quality Control Center doctors regarding factors related to Unplanned Intensive Care Unit Admission
- 武汉大学学报（医学版） 2025年46卷第11期页码：1488-1493
- 作者机构：
  
  1.江汉大学医学部湖北武汉 430056
  2.武汉市第四医院麻醉科湖北武汉 430030
- 作者简介：
  
  张杨，女，1997—，医学硕士生，主要从事麻醉安全与质控方向研究，E‑mail：873091131@qq.com
  彭晓红，女，1962—，主任医师，主要从事老年人围术期认知功能方向研究，E‑mail：pxhong01@hotmail.com
- 基金信息：
- DOI：10.14188/j.1671-8852.2024.0815
  中图分类号： R614
- 收稿：2024-10-28，
  
  纸质出版：2025-11-25
- 稿件说明：
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张杨,彭晓红,张佩茹等.武汉市麻醉质控中心医师对非计划转入ICU相关因素认知调查分析[J].武汉大学学报（医学版）,2025,46(11):1488-1493.

ZHANG Yang,PENG Xiaohong,ZHANG Peiru,et al.Investigation on the perception of Wuhan Anesthesia Quality Control Center doctors regarding factors related to Unplanned Intensive Care Unit Admission[J].Medical Journal of Wuhan University,2025,46(11):1488-1493.
张杨,彭晓红,张佩茹等.武汉市麻醉质控中心医师对非计划转入ICU相关因素认知调查分析[J].武汉大学学报（医学版）,2025,46(11):1488-1493. DOI： 10.14188/j.1671-8852.2024.0815.

ZHANG Yang,PENG Xiaohong,ZHANG Peiru,et al.Investigation on the perception of Wuhan Anesthesia Quality Control Center doctors regarding factors related to Unplanned Intensive Care Unit Admission[J].Medical Journal of Wuhan University,2025,46(11):1488-1493. DOI： 10.14188/j.1671-8852.2024.0815.

摘要

目的

调查武汉麻醉质控中心平台所属医院麻醉医师对非计划转入ICU的认知情况，分析围术期非计划转入ICU相关因素。

方法

采用问卷的形式对麻醉医师进行调查，主要分为麻醉医师对质控指标的了解程度、非计划转入ICU相关因素、医院科室建设及个人信息四部分。数据以百分比和95%置信区间的形式表示，分类变量使用卡方检验，

0.05则认为差异具有统计学意义，对非计划转入ICU年发生率的变化采用卡方拟合优度分析，可预防性采用

‑

因子分析。

结果

高年资、高级职称的麻醉医师对非计划转入ICU的了解程度和麻醉不良事件上报流程的了解程度较高。二级与三级医院在科室建设方面存在差异性。根据问卷反馈，从麻醉因素、手术因素、患者个体特征、科室建设四个方面整理出与非计划转入ICU有相关性的因素，麻醉医师认为非计划转入ICU与患者个体特征相关性更大，其他依次为手术因素、科室建设因素与麻醉因素。

结论

高级职称与高年资的麻醉医师对非计划转入ICU及上报流程的熟悉程度更高。三级医院在科室建设方面优于二级医院。参与本次问卷调查的麻醉医师认为与非计划转入ICU存在相关性因素有美国麻醉医师协会(ASA)评级高，合并呼吸系统与循环系统性疾病，急诊手术、夜间手术、长时间手术、胃肠外科、心胸血管外科和神经外科手术、医师能力等。

Abstract

Objective

To investigate anesthesiologists' awareness of unplanned ICU admissions and associated risk factors across 39 hospitals within the Wuhan Anesthesia Quality Control Center platform.

Methods

A questionnaire survey was conducted covering four domains: understanding of quality⁃control indicators

risk factors for unplanned ICU admissions

departmental infrastructure

and personal information. Data were presented as percentages with 95% confidence intervals. Chi⁃square tests were used for categorical variables

with

0.05 considered statistically significant. Chi‑square goodness‑of‑fit analysis was used to assess changes in the incidence of unplanned ICU admissions

and

‑

factor analysis was employed for preventive factors.

Results

Anesthesiologists with higher seniority and advanced professional titles had a better understanding of both unplanned ICU admission and the adverse anesthesia event reporting process. There were differences in departmental construction between secondary and tertiary hospitals. Factors related to unplanned ICU admission were categorized into four aspects: anesthesia factors

surgical factors

patient individual characteristics

and departmental construction. Anesthesiologists believe that patient individual characteristics have the greatest relevance to unplanned ICU admission

followed by surgical factors

departmental construction and anesthesia factors.

Conclusion

Anesthesiologists with higher professional titles and more years of experience have a greater familiarity with unplanned ICU admissions and reporting processes. There are significant differences between secondary and tertiary hospitals idepartmental construction. Anesthesiologists participating in this survey identified factors related to unplanned ICU admissions as primarily involving high American Society of Anesthesiologists (ASA) ratings

concurrent respiratory and circulatory system diseases

emergency surgeries

nocturnal surgery

long‑duration surgery

gastrointestinal

thoracic and cardiovascular

and neurosurgery surgery

capabilities.

关键词

Keywords

references

CAMMAROTA G , DE ROBERTIS E , SIMONTE R . Unexpected intensive care unit admission after surgery: Impact on clinical outcome [J ] . Curr Opin Anaesthesiol , 2024 , 37 ( 2 ): 192 ‑ 198 .

RAMOS J G R , DOS SANTOS G M N , BISPO M C C , et al . Unplanned transfers from intermediate care units to intensive care units: A cohort study [J ] . Am J Crit Care , 2021 , 30 ( 5 ): 397 ‑ 400 .

MEZIANE M , EL JAOUHARI S D , ELKOUNDI A , et al . Unplanned intensive care unit admission following elective surgical adverse events: Incidence, patient characteristics, preventability, and outcome [J ] . Indian J Crit Care Med , 2017 , 21 ( 3 ): 127 ‑ 130 .

MULVEY H E , HASLAM R D , LAYTIN A D , et al . Unplanned ICU admission is associated with worse clinical outcomes in geriatric trauma patients [J ] . J Surg Res , 2020 , 245 : 13 ‑ 21 .

RANNEY S E , AMATO S , CALLAS P , et al . Delay in ICU transfer is protective against ICU readmission in trauma patients: A naturally controlled experiment [J ] . Trauma Surg Acute Care Open , 2021 , 6 ( 1 ): e000695 .

BRUNELLI A , BEGUM H , CHAUDHURI N , et al . A risk model to predict an unplanned admission to the intensive care unit following lung resection [J ] . Eur J Cardiothorac Surg , 2022 , 61 ( 6 ): 1232 ‑ 1239 .

BOS M M , DE KEIZER N F , MEYNAAR I A , et al . Outcomes of cancer patients after unplanned admission to general intensive care units [J ] . Acta Oncol , 2012 , 51 ( 7 ): 897 ‑ 905 .

马爽 , 申乐 , 黄宇光 , 等 . 2018年麻醉医疗质量管理现状报告 [J ] . 中国卫生质量管理 , 2020 , 27 ( 1 ): 9 ‑ 13 .

MA S , SHEN L , HUANG Y G , et al . Status report of anesthesia medical quality management in 2018 [J ] . Chin Health Qual Manag , 2020 , 27 ( 1 ): 9 ‑ 13 .

ZHANG G , SUN S , DONG Z , et al . Risk factors for unplanned intensive care unit admission after esophagectomy: A retrospective cohort study of 628 patients with esophageal cancer [J ] . Front Oncol , 2024 , 14 : 1420446 .

KATORI N , YAMAKAWA K , YAGI K , et al . Characteristics and outcomes of unplanned intensive care unit admission after general anesthesia [J ] . BMC Anesthesiol , 2022 , 22 ( 1 ): 191 .

陈冬翠 , 郭文军 , 冯茂良 . 手术室不良事件报告系统的建立与应用 [J ] . 麻醉安全与质控 , 2020 , 4 ( 6 ): 356 ‑ 359 .

CHEN D C , GUO W J , FENG M L . The establishment and application of the adverse event reporting system in the operating room [J ] . Perioper Saf Qual Assur , 2020 , 4 ( 6 ): 356 ‑ 359 .

ONWOCHEI D N , FABES J , WALKER D , et al . Critical care after major surgery: A systematic review of risk factors for unplanned admission [J ] . Anaesthesia , 2020 , 75 ( Suppl 1 ): e62 ‑ e74 .

MELTON M S , LI Y J , POLLARD R , et al . Unplanned hospital admission after ambulatory surgery: A retrospective, single cohort study [J ] . Can J Anesth Can D'anesthésie , 2021 , 68 ( 1 ): 30 ‑ 41 .

YETNEBERK T , FIRDE M , TIRUNEH A , et al . Incidence of unplanned intensive care unit admission following surgery and associated factors in Amhara regional state hospitals [J ] . Sci Rep , 2022 , 12 : 20121 .

WANDERER J P , ANDERSON‑DAM J , LEVINE W , et al . Development and validation of an intraoperative predictive model for unplanned postoperative intensive care [J ] . Anesthesiology , 2013 , 119 ( 3 ): 516 ‑ 524 .

CAO Q , FAN C , LI W , et al . Unplanned post‑anesthesia care unit to ICU transfer following cerebral surgery: A retrospective study [J ] . Biol Res Nurs , 2023 , 25 ( 1 ): 129 ‑ 136 .

GRIMSHAW K S , FAN K , MULLINS A , et al . Using quality improvement methods to understand incidence, timing, and factors associated with unplanned intensive care unit transfers of patients with end‑stage liver disease [J ] . Prog Transplant , 2019 , 29 ( 4 ): 361 ‑ 363 .

董雪 , 高巨 . 夜间手术增加围术期不良事件的研究进展 [J ] . 临床麻醉学杂志 , 2020 , 36 ( 8 ): 827 ‑ 828 .

DONG X , GAO J . Research progress of increasing perioperative adverse events after nocturnal surgery [J ] . J Clin Anesthesiol , 2020 , 36 ( 8 ): 827 ‑ 828 .

QUINN T D , GABRIEL R A , DUTTON R P , et al . Analysis of unplanned postoperative admissions to the intensive care unit [J ] . J Intensive Care Med , 2017 , 32 ( 7 ): 436 ‑ 443 .

席元晨 , 康静 , 刘亚梅 , 等 . 新型危重症评分量表对患者转入重症监护室及死亡的预测价值 [J ] . 重庆医学 , 2024 , 53 ( 14 ): 2138 ‑ 2142 .

XI Y C , KANG J , LIU Y M , et al . Predictive value of new type critical illness score scale for patients transferred to intensive care units and death [J ] . Chongqing Med J , 2024 , 53 ( 14 ): 2138 ‑ 2142 .

DAVIS N , LINDBLOOM P , HROMATKA K , et al . Use of an Integrated Pulmonary Index pathway decreased unplanned ICU admissions in elderly patients with rib fractures [J ] . Trauma Surg Acute Care Open , 2024 , 9 ( 1 ): e001523 .

陈东华 , 赵红梅 , 尚小溥 , 等 . 数据驱动的大型医院手术室运营预测与优化方法研究 [J ] . 数据分析与知识发现 , 2021 , 5 ( 9 ): 115 ‑ 128 .

CHEN D H , ZHAO H M , SHANG X P , et al . Optimizing large hospital operating rooms with data analytics [J ] . Data Anal Knowl Discov , 2021 , 5 ( 9 ): 115 ‑ 128 .

卢可健 . 麻醉前床旁超声评估对急诊手术危重患者麻醉决策和预后的影响 [D ] . 南宁 : 广西医科大学 , 2020 .

LU K J . Effect of bedside ultrasound evaluation before anesthesia on anesthesia decision‑making and prognosis of critically ill patients undergoing emergency surgery [D ] . Nanning : Guangxi Medical University , 2020 .

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