Erratum: Opening of a Respiratory Intermediate Care Unit in a General Hospital: Impact on Mortality and Other Outcomes

<b><i>Background:</i></b> Respiratory intermediate care units (RICUs) are specialized areas aimed at optimizing the cost-benefit ratio of care. No data exist about the impact of opening a RICU on hospital outcomes. <b><i>Objectives:</i></b> We wondered if opening a RICU may improve the outcomes of patients with acute respiratory failure (ARF), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), or community-acquired pneumonia (CAP). <b><i>Methods:</i></b> We analyzed the discharge abstracts of 2,372 admissions to the RICU and internal medicine units (IMUs) for ARF, AECOPD, and CAP. The IMUs at the Hospital of Trieste comprise emergency and internal wards. In order to investigate the determinants of outcomes, a matched case-control study was performed using clinical records. <b><i>Results:</i></b> The in-hospital mortality rate was lower in the RICU vs. IMUs (5.4 vs. 19.1%, p = 0.0001). Statistical differences did not change when comparing the RICU with the emergency and internal wards. After adjusting for potential confounders, the risk of death for patients with CAP, AECOPD, or ARF was significantly higher in the IMUs than in the RICU (OR 6.90, 3.19, and 6.7, respectively, p &lt; 0.04). Both the frequency of transfer to the ICU (6 vs. 12%, p = 0.0001, OR 0.38) and the hospital stay (9.3 vs. 12.1 days, p = 0.0001) were reduced in patients admitted to the RICU compared to those admitted to non-RICUs. Significant differences were found in care management concerning chest physiotherapy, mechanical ventilation, antibiotics, and corticosteroids. <b><i>Conclusions:</i></b> The opening of a RICU may be advantageous to reduce in-hospital mortality, the need for ICU admission, and the hospital stay of patients with AECOPD, CAP, and ARF. Better use of care resources contributed to better patient management in the RICU.

**背景：** 呼吸专科中间监护单元（RICUs）是一类旨在优化医疗照护成本效益比的专科诊疗单元，目前尚无关于开设RICUs对医院诊疗结局影响的相关研究数据。
**目标：** 本研究旨在探讨开设呼吸专科中间监护单元是否可改善急性呼吸衰竭（ARF）、慢性阻塞性肺疾病急性加重（AECOPD）及社区获得性肺炎（CAP）患者的诊疗结局。
**方法：** 本研究分析了针对ARF、AECOPD及CAP患者的2372例呼吸专科中间监护单元（RICUs）与内科病房（IMUs）住院患者的出院摘要数据。的里雅斯特医院的内科病房涵盖急诊病房与普通内科病房。为探究影响诊疗结局的相关因素，本研究基于临床病历开展了匹配式病例对照研究。
**结果：** 呼吸专科中间监护单元患者的院内死亡率低于内科病房患者（5.4% vs. 19.1%，p=0.0001）。将呼吸专科中间监护单元分别与急诊病房、普通内科病房对比时，上述统计学差异仍保持一致。在校正潜在混杂因素后，内科病房中CAP、AECOPD及ARF患者的死亡风险均显著高于呼吸专科中间监护单元患者（比值比[OR]分别为6.90、3.19和6.7，p<0.04）。与非呼吸专科中间监护单元收治的患者相比，呼吸专科中间监护单元患者的ICU转诊率（6% vs. 12%，p=0.0001，OR=0.38）与住院时长（9.3天 vs. 12.1天，p=0.0001）均显著降低。在胸部物理治疗、机械通气、抗生素及糖皮质激素的诊疗管理方面，两组间亦存在显著差异。
**结论：** 开设呼吸专科中间监护单元有助于降低AECOPD、CAP及ARF患者的院内死亡率、ICU转诊需求与住院时长。呼吸专科中间监护单元对医疗资源的优化配置，有效提升了患者的诊疗管理质量。