Hypothermia with indoor occurrence is associated with a worse outcome
Hypothermia with indoor occurrence is associated with a worse outcome
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DOI：
10.1007/s001340000702
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发表时间：
2000-12-01
影响因子：
38.9
通讯作者：
Brivet, FG
中科院分区：
文献类型：
--
作者：
Mégarbane, B;Axler, O;Brivet, FG
目的：描述因体温过低而入住重症监护病房 (ICU) 的患者，评估预后因素，并检验室内患者预后较差的假设。设计和设置：在医疗 ICU 中进行回顾性临床调查。患者：17 年来连续入住 ICU 的 81 名体温不超过 35 摄氏度并采用被动或微创技术复温的患者。测量和结果：按年龄、性别、以及体温过低的原因，并根据体温过低发生的位置分为两组（室内和室外）。通过单变量方法和逐步逻辑回归确定预后因素。主要并发症为急性肾功能衰竭（43%）、吸入性肺炎（22%）、横纹肌溶解症（22%）和急性呼吸窘迫综合征（12%）。室外患者的主要合并症（21%）是酒精和药物中毒，室内患者的主要合并症（79%）是败血症和神经精神疾病。逐步逻辑回归确定了两个预测死亡的变量：入院时的疾病严重程度（SAPS II 大于或等于 40）和体温过低发生的位置（室内与室外）。结论：在体温相同的情况下，室内患者比室外患者受影响更严重，死亡频率更高。
Objective:To describe patients admitted to intensive care unit (ICU) for hypothermia, evaluate prognostic factors, and test the hypothesis that patients found indoors have a worse outcome.Design and setting: Retrospective clinical investigation in a medical ICU.Patients: Eighty-one consecutive patients admitted to ICU, with a body temperature of 35 degreesC or lower and rewarmed passively or with minimally invasive techniques, over a 17-year period.Measurements and results: Patients were analyzed by age, gender, and causes of hypothermia and split into two groups (indoors and outdoors), according to the location where hypothermia occurred. Prognostic factors were determined by univariate method and stepwise logistic regression. The major complications were acute renal failure (43 %), aspiration pneumonia (22 %), rhabdomyolysis (22 %), and acute respiratory distress syndrome (12%). Principal comorbidities in the outdoor patients (21%) were alcohol and drug intoxication, and those in the indoor patients (79 %) were sepsis and neuropsychiatric disorders. Stepwise logistic regression identified two variables predictive of death: illness severity at admission (SAPS II greater than or equal to 40) and the location where hypothermia occurred (indoors versus outdoors).Conclusions: With equivalent body temperature, patients found indoors were more severely affected and died more frequently than those found outdoors.