PROGNOSIS IN ACUTE ORGAN-SYSTEM FAILURE
PROGNOSIS IN ACUTE ORGAN-SYSTEM FAILURE
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DOI：
10.1097/00000658-198512000-00004
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发表时间：
1985-01-01
影响因子：
9
通讯作者：
ZIMMERMAN, JE
中科院分区：
文献类型：
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作者：
KNAUS, WA;DRAPER, EA;ZIMMERMAN, JE
这项前瞻性研究描述了急性器官系统（OSF）患者当前的预后。为 5 个 OSF 制定了客观定义，然后对 13 家医院的 5677 名 ICU 入院患者进行了监测。对于 2719 名发生 OSF 的 ICU 患者 (48%)，OSF 的数量和持续时间与出院时的结果相关。对于所有内科入院和大多数外科入院，单次 OSF 持续超过 1 天导致死亡率接近 40%。在内科和外科患者中，两次 OSF 超过 1 天会使死亡率增加至 60%。年龄较大会增加发生 OSF 的可能性以及发生 OSF 后死亡的可能性。 99 名患有 3 个或更多 OSF 3 天后持续存在的患者的死亡率为 98%。幸存的两名患者均年轻，既往健康状况良好，患有严重但有限的原发病。这些结果强调了与急性 OSF 相关的高死亡率以及死亡率随着时间的推移而迅速增加。预后估计为治疗类似患者的医生提供参考数据。
This prospective study describes the current prognosis of patients in acute Organ System (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU patients (48%) who developed OSF. For all medical and most surgical admissions, a single OSF lasting more than 1 day resulted in a mortality rate approaching 40%. Among both medical and surgical patients, two OSFs for more than 1 day increased death rates to 60%. Advanced chronologic age increased both the probability of developing OSF and the probability of death once OSF occurred. Mortality for 99 patients with three or more OSFs persisting after 3 days was 98%. The two patients who survived were both young, in prior excellent health, and had severe but limited primary diseases. These results emphasize the high death rates associated with acute OSF and the rapidity with which mortality increases over time. The prognostic estimates provide reference data for physicians treating similar patients.