Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit.
Risk factors for mortality and mortality rates in interstitial lung disease patients in the intensive care unit.
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DOI：
10.1183/16000617.0061-2018
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发表时间：
2018-12-31
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影响因子：
--
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由于人群异质性，重症监护室（ICU）间质性肺病（ILD）结局的数据价值有限。本研究的目的是检查ICU中死亡率和ILD死亡率的危险因素。我们使用5个数据库进行了系统评价。共识别出50项研究，其中34项研究被纳入：17项研究涉及ILD的各种病因（混合型ILD），17项研究涉及特发性肺纤维化（IPF）。在混合型ILD中，APACHE评分升高、低氧血症和机械通气是死亡的危险因素。未发现使用类固醇增加死亡率。关于高龄的证据是不确定的。在IPF中，除机械通气和低氧血症外，所有因素的证据均不确定。在15项关于混合型ILD的研究（2001-2009年为62%，2010-2017年为48%）和15项关于IPF的研究（1993-2004年为79%，2005-2017年为65%）中提供了总体住院死亡率。1年随访死亡率范围为53%-100%。 无论ILD病因如何，机械通气均与死亡率增加相关。对于混合型ILD，低氧血症和APACHE评分也与死亡率增加相关。IPF在ILD中的死亡率最高，但自1993年以来，死亡率似乎在下降。尽管提高了住院生存率，但总死亡率仍然很高。APACHE评分升高、低氧血症和机械通气是ILD死亡的危险因素。未发现使用类固醇增加死亡率。关于高龄的证据尚无定论。随着时间的推移，生存率可能会提高，但仍然很高。http://ow.ly/6F1d30mijdy
Data on interstitial lung disease (ILD) outcomes in the intensive care unit (ICU) is of limited value due to population heterogeneity. The aim of this study was to examine risk factors for mortality and ILD mortality rates in the ICU. We performed a systematic review using five databases. 50 studies were identified and 34 were included: 17 studies on various aetiologies of ILD (mixed-ILD) and 17 on idiopathic pulmonary fibrosis (IPF). In mixed-ILD, elevated APACHE score, hypoxaemia and mechanical ventilation are risk factors for mortality. No increased mortality was found with steroid use. Evidence is inconclusive on advanced age. In IPF, evidence is inconclusive for all factors except mechanical ventilation and hypoxaemia. The overall in-hospital mortality was available in 15 studies on mixed-ILD (62% in 2001–2009 and 48% in 2010–2017) and 15 studies on IPF (79% in 1993–2004 and 65% in 2005–2017). Follow-up mortality rate at 1 year ranged between 53% and 100%. Irrespective of ILD aetiology, mechanical ventilation is associated with increased mortality. For mixed-ILD, hypoxaemia and APACHE scores are also associated with increased mortality. IPF has the highest mortality rate among ILDs, but since 1993 the rate appears to be declining. Despite improving in-hospital survival, overall mortality remains high. Elevated APACHE score, hypoxaemia and mechanical ventilation are risk factors for mortality in ILD. No increased mortality was found with steroid use. Evidence on advanced age is inconclusive. Survival may be improving over time, but still remains high. http://ow.ly/6F1d30mijdy
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影响因子：
24.3
作者：
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