Quality metrics and outcomes among critically ill patients in China:results of the national clinical quality control indicators for critical care medicine survey 2015-2019

作     者：Xi Rui Fen Dong Xudong Ma Longxiang Su Guangliang Shan Yanhong Guo Yun Long Dawei Liu Xiang Zhou Xi Rui;Fen Dong;Xudong Ma;Longxiang Su;Guangliang Shan;Yanhong Guo;Yun Long;Dawei Liu;Xiang Zhou;on behalf of China-NCCQC Group

作者机构：Department of Critical Care MedicinePeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100029China Institute of Clinical Medical SciencesChina-Japan Friendship HospitalBeijing 100029China Department of Medical AdministrationNational Health Commission of the People's Republic of ChinaBeijing 100044China Department of Epidemiology and BiostatisticsInstitute of Basic Medicine SciencesChinese Academy of Medical Sciences(CAMS)&School of Basic MedicinePeking Union Medical CollegeBeijing 100005China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2022年第135卷第9期

页      面：1064-1075页

核心收录：

学科分类：100218[医学-急诊医学] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

基　　金：National Key R&D Program of China(No.2020YFC0861000) the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2020-I2M-CoV19-001) the China International Medical Exchange Foundation Special Fund for Young and Middle-Aged Medical Research(No.Z-2018-35-1902) the 2020 CMB Open Competition Program(No.20-381) the Chinese Medical Information and Big Data Association(CHMIA)Special Fund for Emergency Project and Beijing Municipal Natural Science Foundation(M21019) 

主　　题：Medical quality ICU China Epidemiological survey 

摘      要：Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to ***:This was an ICU-level study based on a 15-indicator online survey conducted in *** that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/*** analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥*** proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU *** proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital *** the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 *** overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are hetero