Can the Wish to Receive Intensive Treatment in Elderly Patients with Respiratory Tract Infection Be Predicted?
Can the Wish to Receive Intensive Treatment in Elderly Patients with Respiratory Tract Infection Be Predicted?
复制标题
DOI：
10.2169/internalmedicine.0155-17
复制
发表时间：
2018-07-15
期刊：
影响因子：
--
通讯作者：
Oshima K
中科院分区：
文献类型：
--
作者：
Hagiwara S;Kaneko M;Aoki M;Murata M;Ichikawa Y;Nakajima J;Isshiki Y;Sawada Y;Tamura J;Oshima K
几乎没有日本老年患者有预先指令（AD）。我们的目的是确定是否希望接受重症监护的老年呼吸道感染患者可以预测从院前数据。 在这项回顾性研究中，我们回顾了2014年9月至2016年8月期间由救护车转移到我院的≥65岁呼吸道感染患者。根据患者是否希望接受强化治疗，将其分为两组。我们将不希望接受强化治疗（WITS）的患者置于A组，将WITS患者置于B组。然后，我们分析了可以在院前阶段确定的参数，并比较了两组之间的结果。 A组37例，B组67例。本研究中没有患者患有AD。在单因素分析中，年龄、在扩展护理机构的居住率、不能完全照顾自己的频率、痴呆的频率、处方药物的数量和格拉斯哥昏迷量表（GCS）有显著差异。Logistic回归分析显示，不能完全照顾自己[比值比（OR）：4.521，95%置信区间（CI）：2.024-10.096，p<0.001]和低GCS（OR 0.885，95%CI 0.838-0.935，p<0.001）与WITS相关。 不能照顾自己和院前阶段GCS较低的老年患者可能不需要强化治疗。
Almost no Japanese elderly patients have an advance directive (AD). Our aim was to determine whether or not the wish to receive intensive care in elderly patients with respiratory tract infection could be predicted from the prehospital data. In this retrospective study, we reviewed patients ≥65 years of age with respiratory tract infection who had been transferred to our hospital by ambulance between September 2014 and August 2016. The patients were divided into two groups according to whether or not they wished to receive intensive treatment. We placed patients without a wish to receive intensive treatments (WITs) in Group A and patients with a WITs in Group B. We then analyzed parameters that could be determined in the prehospital phase and compared the findings between the groups. Thirty-seven patients were in Group A, and 67 patients were in Group B. None of the patients in this study had an AD. There were significant differences in the age, rate of residence in an extended care facility, frequency of inability to care for oneself fully, frequency of dementia, number of prescribed drugs, and Glasgow coma scale (GCS) on a univariate analysis. A logistic regression analysis showed that the inability to care for oneself fully [odds ratio (OR): 4.521, 95% confidence interval (CI): 2.024-10.096, p<0.001] and a low GCS (OR 0.885, 95%CI 0.838-0.935, p<0.001) were related to a WITs. Elderly patients who are unable to care for themselves and who have a low GCS in the prehospital stage are likely not to want intensive treatment.
登录
查看更多内容
DOI：
10.1016/j.jamda.2004.12.006
发表时间：
2005-01-01
影响因子：
7.6
作者：
Messinger-Rapport, Barbara J;Kamel, Hosam K
通讯作者：
Kamel, Hosam K
影响因子：
8.8
作者：
Vincent, JL;de Mendonca, A;Blecher, S
通讯作者：
Blecher, S
DOI：
10.1186/cc12783
发表时间：
2013-06-20
期刊：
Critical care (London, England)
影响因子：
--
作者：
Gando S;Saitoh D;Ogura H;Fujishima S;Mayumi T;Araki T;Ikeda H;Kotani J;Kushimoto S;Miki Y;Shiraishi S;Suzuki K;Suzuki Y;Takeyama N;Takuma K;Tsuruta R;Yamaguchi Y;Yamashita N;Aikawa N;Japanese Association for Acute Medicine Sepsis Registry Study Group
通讯作者：
Japanese Association for Acute Medicine Sepsis Registry Study Group
DOI：
10.1016/j.jamda.2008.10.015
发表时间：
2009-05-01
影响因子：
7.6
作者：
Daaleman, Timothy P.;Williams, Christianna S.;Zimmerman, Sheryl
通讯作者：
Zimmerman, Sheryl
影响因子：
120.7
作者：
Singer, Mervyn;Deutschman, Clifford S.;Angus, Derek C.
通讯作者：
Angus, Derek C.