Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies
Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies
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DOI：
10.1053/ajkd.2002.34505
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发表时间：
2002-08-01
影响因子：
13.2
通讯作者：
Neumayer, HH
中科院分区：
文献类型：
--
作者：
Morgera, S;Kraft, AK;Neumayer, HH
背景：有限的卫生保健预算提出了应该为多器官急性肾功能衰竭（ARF）重症患者提供多少治疗的问题。没有关于ARF患者出院后的数据。方法：评估患者出院后的长期生存和生活质量。对979例需要持续肾替代治疗的ARF患者进行回顾性分析。接触是通过评估健康状况和身心健康的问卷进行的。结果：住院死亡率为69% （n = 678）。89% （n = 267）患者获得出院后信息。Kaplan-Meier分析显示出院后生存率出奇的好。出院患者前6个月生存率为77%。那些这样做的人在接下来的6个月里有89%的存活率。5年后，生存率为50%。年龄和住院前不止一种合并症与出院后生存率显著降低相关。77%的受访者认为他们目前的健康状况为良好至优秀，57%的人自我维持，49%的人表示他们的生活质量得到了改善。41%的患者肾功能不全，而10%的患者需要慢性透析治疗。结论：ARF与高住院死亡率相关。尽管如此，出院患者的存活率和生活质量都很好。我们的结论是，积极的重症监护病房治疗是合理的在这些患者。(C) 2002年由国家肾脏基金会，Inc。
Background: Limited health care budgets have raised the issue of how much therapy should be dedicated to critically ill patients with multiorgan and acute renal failure (ARF). No data are available on patients with ARF after hospital discharge. Methods: We assessed long-term survival and quality of life after discharge. Nine hundred seventy-nine patients with ARF who needed continuous renal replacement therapies were analyzed retrospectively. Contact was achieved by questionnaires assessing health status and mental and physical well-being. Results: The in-hospital mortality rate was 69% (n = 678). Postdischarge information was obtained from 89% (n = 267). Kaplan-Meier analyses showed surprisingly good postdischarge survival. Discharged patients had a 77% probability to survive the first 6 months. Those who did so had a probability of 89% to survive the following 6 months. After 5 years, the survival probability was 50%. Age and more than one comorbidity before hospitalization were associated with significantly lower postdischarge survival. Seventy-seven percent of questionnaire responders assessed their current health status as good to excellent, 57% were self-sustaining, and 49% stated that their quality of life had improved. Renal insufficiency remained in 41%, whereas 10% required chronic dialysis therapy. Conclusion: ARF is associated with a high in-hospital mortality rate. Nevertheless, patients leaving the hospital had a reasonable survival rate and good quality of life. We conclude that aggressive intensive care unit treatment is justified in these patients. (C) 2002 by the National Kidney Foundation, Inc.