Loss of autonomy among elderly patients after a stay in a medical intensive care unit (ICU): A randomized study of the benefit of transfer to a geriatric ward
Loss of autonomy among elderly patients after a stay in a medical intensive care unit (ICU): A randomized study of the benefit of transfer to a geriatric ward
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DOI：
10.1016/j.archger.2009.05.001
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发表时间：
2010-05-01
影响因子：
4
通讯作者：
Saint-Jean, Olivier
中科院分区：
文献类型：
--
作者：
Somme, Dominique;Andrieux, Nathalie;Saint-Jean, Olivier
为了评估老年患者在医疗重症监护病房（ICU）住院后功能自主性的变化，以及老年病房ICU后管理的影响，我们纳入了45例年龄为bb0 = 75岁的患者进行随机对照试验。分别在ICU入住前、ICU出院后、出院后和6个月后对患者进行功能自主评估。患者随机分为“老年病房”和“标准护理”两个icu后管理组。自主性通常很快恢复，但恢复程度取决于患者以前的自主性（p < 0.0001）。在最后一次评估中，41%的患者恢复了以前的自主性。老年管理组平均Barthel指数为81.5 +/- 30.4，标准管理组平均Barthel指数为70.5 +/- 33.4 （p = 0.4）。由于招聘流量不足，研究提前结束。这些结果强调了在ICU住院后自主性的迅速丧失。早期特异性干预提高老年患者的自主性似乎是一个有吸引力的解决方案，可以通过随机对照试验进行评估。最重要的是，我们的结果也应该作为进一步在这种情况下进行对照随机研究的基础。2009爱思唯尔爱尔兰有限公司版权所有。
In order to evaluate changes in the functional autonomy of elderly patients after a stay in a medical intensive care unit (ICU), and the impact of post-ICU management in geriatric ward, we included in a randomized controlled trial 45 patients aged >= 75 years. They were assessed for functional autonomy before ICU stay, just after ICU discharge, just after hospital discharge, and 6 months later. The patients were randomly divided into two post-ICU management groups: "geriatric ward'' and "standard care''. Autonomy was usually recovered rapidly, but the degree of recovery depended on the patient's previous autonomy (p < 0.0001). At the last assessment, 41% of the patients had recovered their previous autonomy. The mean Barthel indexes were 81.5 +/- 30.4 in the geriatric management arm and 70.5 +/- 33.4 in the standard management arm (p = 0.4). The study was prematurely ended due to insufficient recruitment flow. These results underline the rapid loss of autonomy after a stay in a medical ICU. Early specific intervention to improve the autonomy of elderly patients seems an attractive solution that could be assessed by randomized controlled trial. Above all, our results should also serve as a basis for further controlled randomized studies in this setting. (C) 2009 Elsevier Ireland Ltd. All rights reserved.