Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit.
Long-term outcome in medical patients aged 80 or over following admission to an intensive care unit.
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DOI：
10.1186/cc9984
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Papazian L
中科院分区：
文献类型：
--
作者：
Roch A;Wiramus S;Pauly V;Forel JM;Guervilly C;Gainnier M;Papazian L
本研究的目的是评估影响80岁及以上内科患者进入重症监护室后短期和长期生存的因素。本研究纳入了2001年至2006年期间收治的所有80岁或以上患者。从入院到2009年6月评估生存率;确定与死亡率相关的因素。使用SF-36量表对长期生存者的健康相关生活质量进行评估。对于纳入的299例患者（平均年龄，84 ± 4岁），住院死亡率为55%。与住院死亡率独立相关的因素是ICU入院时较高的SAPS II评分; McCabe评分反映的致命疾病的存在和入院时的心脏诊断。在133名住院生存者中，中位生存时间为710天（95%CI，499 - 921）。初始队列的两年死亡率为79%，住院存活者为53%。与一般人群的年龄和性别校正死亡率相比，出院后2年的标准化死亡率比值为2.56（95%CI，2.08 - 3.12）。与出院后2年死亡率独立相关的因素是ICU入院时的SAPS II评分和McCabe评分。相反，入院前的功能状态，如Knaus或Karnofsky评分评估与长期死亡率无关。在长期存活者中，SF-36身体功能评分较差，但疼痛、情感健康和社会功能评分没有受到太大影响。入院时急性疾病的严重程度影响80岁或以上患者的住院死亡率和出院后死亡率。尽管出院的患者中有高达50%的患者在2年时仍然存活，但与一般人群相比，死亡率有所增加。长期住院幸存者的身体功能发生了很大变化。
The aim of this study was to evaluate factors influencing short- and long-term survival in medical patients aged 80 and over following admission to an intensive care unit. All patients aged 80 years or over and admitted between 2001 and 2006 were included in this study. Survival was evaluated between the time of admission and June 2009; factors associated with mortality were determined. Health-related quality of life was evaluated using Short Form (SF)-36 in long-term survivors. For the 299 patients included (mean age, 84 ± 4 y), hospital mortality was 55%. Factors independently associated with hospital mortality were a higher SAPS II score at ICU admission; the existence of a fatal disease as reflected by the McCabe score and a cardiac diagnosis at admission. In the 133 hospital survivors, median survival time was 710 days (95% CI, 499-921). Two-year mortality rates were 79% of the initial cohort and 53% of hospital survivors. The standardized ratio of mortality at 2 years after hospital discharge was 2.56 (95% CI, 2.08-3.12) when compared with age- and gender-adjusted mortality of the general population. Factors independently associated with mortality at 2 years after hospital discharge were SAPS II score at ICU admission and the McCabe score. Conversely, functional status prior to admission as assessed by Knaus or Karnofsky scores was not associated with long-term mortality. In long-term survivors, SF-36 physical function scores were poor but scores for pain, emotional well-being and social function were not much affected. The severity of acute disease at admission influences mortality at the hospital and following discharge in patients aged 80 or over. Although up to 50% of patients discharged from the hospital were still alive at 2 years, mortality was increased when compared with the general population. Physical function of long-term hospital survivors was greatly altered.
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影响因子：
24.3
作者：
Bregeon, F;Papazian, L;Auffray, JP
通讯作者：
Auffray, JP
影响因子：
10.7
作者：
Djaiani, G;Ridley, S
通讯作者：
Ridley, S
影响因子：
3.5
作者：
Sjögren, J;Thulin, LI
通讯作者：
Thulin, LI
影响因子：
--
作者：
MCCABE, WR;JACKSON, GG
通讯作者：
JACKSON, GG
影响因子：
38.9
作者：
Boumendil, A;Maury, E;Guidet, B
通讯作者：
Guidet, B