Outcome and quality of life of patients with acute kidney injury after major surgery
Outcome and quality of life of patients with acute kidney injury after major surgery
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DOI：
10.3265/nefrologia.2009.29.5.5456.en.full
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发表时间：
2009-01-01
期刊：
影响因子：
--
通讯作者：
Barros, H.
中科院分区：
文献类型：
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作者：
Abelha, F.;Botelho, M.;Barros, H.
背景资料：在发生急性肾损伤（阿基）的术后危重患者中，重要的是要关注出院后的生存率和生活质量。该研究的目的是评估大手术后发生阿基的患者的结局和生活质量。方法：这项回顾性研究是在一个有五张重症监护病床的麻醉后监护室进行的，为期两年。随访患者是否发生阿基。术前特征，术中处理和结果进行了评价。出院后6个月，联系这些患者，以完成简明健康调查表（SF-36），并评估其日常生活活动（ADL）的依赖性。使用卡方或Fischer精确检验比较组间比例。使用独立组的“t检验”和配对“t检验”进行比较。结果：在1597例入住PACU的患者中，1200例患者符合纳入标准。114例患者（9.6%）符合阿基标准。阿基患者病情更严重，在PACU停留的时间更长。在6个月随访的71名住院幸存者中，50人完成了问卷调查。52%的患者报告说，他们在回答问卷当天的总体健康水平比12个月前更好。术后符合阿基标准的患者在身体功能、身体角色和情感角色领域的SF-36评分较差。PACU出院后6个月，符合阿基标准的患者更依赖于工具ADL，而不是个人ADL。结论：尽管阿基患者在ADL任务中具有较高的依赖性，但其生活质量的自我感知得到改善。对于身体功能和角色身体领域，他们的评分比未发生阿基的PACU患者更差。
Background: In postoperative critically-ill patients who develop Acute Kidney Injury (AKI) it is important to focus on survival and quality of life beyond hospital discharge. The aim of the study was to evaluate outcome and quality of life in patients that develop AKI after major surgery. Methods: This retrospective study was carried out in a PostAnaesthesia Care Unit with five intensive care beds during 2 years. Patients were followed for the development of AKI. Preoperative characteristics, intra-operative management and outcome were evaluated. Six months after discharge, these patients were contacted to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in Activities of Daily Living (ADL) evaluated. Chi-square or Fischer's exact test were used to compare proportions between groups. A "t test" and a paired "t test" for independent groups was used for comparisons. Results: Of 1597 patients admitted to the PACU, 1200 patients met the inclusion criteria. One hundred-fourteen patients (9.6%) met AKI criteria. Patients with AKI were more severely ill, stayed longer at the PACU. Among 71 hospital survivors at 6 months follow-up, 50 completed the questionnaires. Fifty-two percent of patients reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients that met AKI criteria after surgery had worse SF-36 scores for physical function, role physical and role emotional domains. Six months after PACU discharge, patients that met AKI criteria were more dependent in Instrumental-ADL but not in Personal-ADL. Conclusions: Patients that develop AKI improved self-perception of quality of life despite having high rate of dependency in ADL tasks. For physical function and role physical domains they had worse scores than PACU patients that did not develop AKI.