LONG-TERM OUTCOME OF CRITICALLY ILL ELDERLY PATIENTS REQUIRING INTENSIVE-CARE
LONG-TERM OUTCOME OF CRITICALLY ILL ELDERLY PATIENTS REQUIRING INTENSIVE-CARE
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DOI：
10.1001/jama.269.24.3119
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发表时间：
1993-06-23
影响因子：
120.7
通讯作者：
GRENVIK, A
中科院分区：
文献类型：
--
作者：
CHELLURI, L;PINSKY, MR;GRENVIK, A
客观。-评估长期死亡率和发病率的危重老年患者需要重症监护。75岁及以上重症患者与65 - 74岁患者预后的前瞻性比较。在3个月期间招募的65岁及以上需要重症监护的危重患者。主要结果测量。住院时间、住院费用、重症监护室使用的程序、医院和随访期间的死亡率以及随访期间幸存者的生活质量。97例患者纳入研究; 54例为75岁或以上，43例为65 - 74岁。两组的住院时间、住院费用或1年死亡率无显著差异。重症监护室入院时通过急性生理学和慢性健康评估评分评估的疾病严重程度是比年龄更好的生存预测因子。出院后1个月、6个月和12个月，两组患者的生活质量（通过日常生活活动、感知生活质量和流行病学中心抑郁评分评估）无显著差异。两组中的大多数患者都描述了他们的生活质量，并愿意在必要时再次接受重症监护。年龄本身并不能充分预测老年危重患者的长期生存和生活质量。
Objective.-To evaluate the long-term mortality and morbidity of critically ill elderly patients requiring intensive care.Design.-Prospective comparison of outcome of critically ill patients aged 75 years and older with patients aged 65 to 74 years.Patients.-Critically ill patients aged 65 years and older who required intensive care and who were recruited during a 3-month period.Main Outcome Measures.-Duration of hospitalization, hospital charges, procedures used in the intensive care unit, mortality in the hospital and during the follow-up period, and quality of life of survivors during the follow-up period.Results.-Ninety-seven patients were included in the study; 54 were 75 years or older and 43 were aged 65 to 74 years. No significant difference was noted between the two groups for length of stay in the hospital, hospital charges, or mortality at 1 year. Severity of illness, as assessed by Acute Physiology and Chronic Health Evaluation score at the time of intensive care unit admission, was a better predictor of survival than age. Quality of life, as assessed by activities of daily living, perceived quality of life, and Center for Epidemiologic Studies-Depression score, were not significantly different in either group at 1, 6, and 12 months after discharge from the hospital. Most patients in both groups described their quality of life as adequate and were willing to receive intensive care again, if necessary.Conclusion.-Age alone is not an adequate predictor of long-term survival and quality of life in critically ill elderly patients.