LIFE EXPECTANCY OF VENTILATOR-DEPENDENT PERSONS WITH SPINAL-CORD INJURIOUS
LIFE EXPECTANCY OF VENTILATOR-DEPENDENT PERSONS WITH SPINAL-CORD INJURIOUS
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DOI：
10.1378/chest.108.1.226
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发表时间：
1995-07-01
期刊：
影响因子：
9.6
通讯作者：
IVIE, CS
中科院分区：
文献类型：
--
作者：
DEVIVO, MJ;IVIE, CS
目的：本研究的目的是评估脊髓损伤（SCI）呼吸机依赖患者的年龄特异性预期寿命。设计：非同期前瞻性研究。设置：联邦指定的SCI护理系统模型。患者：该研究包括1973年至1992年期间入住SCI护理系统的所有435名患者，他们在伤后至少存活24小时，康复出院或出院前仍依赖呼吸机死亡。干预：无。结果测量：标准化死亡率（SMR）、预期寿命和死亡原因。结果：总体1年生存率为25.4%，而15年生存率为16.8%。在第一年存活的患者中，未来14年的累积存活率为61.4%。与1973年至1979年期间的受伤人数相比，1980年以来受伤人数的死亡率下降了60%。与1973年至1979年受伤的人相比，1980年至1985年受伤的人的第1年幸存者随后的死亡率降低了39%，1986年以后受伤的人的死亡率降低了91%。死亡的主要原因是呼吸系统并发症，特别是肺炎。随着这一人群呼吸系统并发症预防和管理方法的改进，预期寿命将继续提高，因此，应更加重视提高这些人的生活质量。
Objective: The purpose of this study is to estimate age-specific life expectancies for ventilator-dependent persons with spinal cord injury (SCI).Design: Nonconcurrent prospective study.Setting: Federally designated model SCI care systems.Patients: The study included all 435 persons admitted to a model SCI care system between 1973 and 1992 who survived at least 24 h postinjury and who were either ventilator dependent at rehabilitation discharge or who died prior to discharge while still ventilator dependent.Intervention: None.Outcome measures: Standardized mortality ratio (SMR), life expectancy, and causes of death.Results: The overall 1-year survival rate was 25.4%, while the 15-year survival rate was 16.8%. Among those who survived the first year, cumulative survival over the next 14 years was 61.4%. The mortality rate for persons injured since 1980 was reduced by 60% compared with persons injured between 1973 and 1979. Among year 1 survivors, the subsequent mortality rate was reduced by 39% for persons injured between 1980 and 1985, and 91% for persons injured since 1986, relative to persons injured between 1973 and 1979, The leading cause of death was respiratory complications, particularly pneumonia.Conclusions: With the development of improved methods of prevention and management of respiratory complications in this population, life expectancies should continue to improve, As a result, additional attention should be focused on enhancing the quality of life for these individuals.