Survival of patients with bronchiectasis after the first ICU stay for respiratory failure
Survival of patients with bronchiectasis after the first ICU stay for respiratory failure
复制标题
DOI：
10.1378/chest.125.5.1815
复制
发表时间：
2004-05-01
期刊：
影响因子：
9.6
通讯作者：
Thomas, R
中科院分区：
文献类型：
--
作者：
Dupont, M;Gacouin, A;Thomas, R
研究目的：呼吸衰竭（RF）是双侧支气管扩张患者的常见死亡原因。ICU入院是常见的要求，无论是短期或长期的结果一直study.Design：我们进行了一项回顾性研究，在10年的时间（1990年1月至2000年3月）。对所有首次入住医疗ICU接受RF治疗的双侧支气管扩张患者进行了审查。测量和结果：48例患者（平均年龄+/- SD，63 +/- 11岁;平均简化急性生理学评分[SAPS] II，32 +/- 12），其中25%接受长期氧疗（LTOT）。所有患者均接受了重症医学护理，其中13例患者（27%）接受了无创通气，26例患者（54%）需要插管。9名患者（19%）在ICU死亡。1年死亡率为40%。通过考克斯回归分析，在ICU入院时记录的变量中，年龄> 65岁（p = 0.002）、SAPS II评分> 32（p = 0.012）、使用LTOT（p = 0.047）和插管（p = 0.027）与生存率降低相关。采用考克斯比例风险模型进行多因素分析，年龄> 65岁（相对风险[RR]，2.70; 95%置信区间[CI]，1.15 - 6.29）和使用LTOT（RR，2.52; 95%CI，1.15至5.54）与生存率降低独立相关。我们进行了第一项研究，提供了关于首次ICU停留RF对双侧支气管扩张患者长期结局影响的相关信息。年龄> 65岁和既往使用LTOT与生存率降低相关。
Study objectives: Respiratory failure (RF) is a frequent cause of death among patients with bilateral bronchiectasis. An ICU admission is commonly required, and neither short-term or long-term outcomes have been studied.Design: We performed a retrospective study over a 10-year period (January 1990 to March 2000). All patients with bilateral bronchiectasis admitted for the first time in the medical ICU for RF were reviewed. Patients with cystic fibrosis were excluded.Measurements and results: Forty-eight patients (mean age +/- SD, 63 +/- 11 years; mean simplified acute physiology score [SAPS] II, 32 +/- 12) of whom 25% received long-term oxygen therapy (LTOT) were identified. All the patients were treated with intensive medical care, associated with noninvasive ventilation in 13 patients (27%), and 26 patients (54%) required intubation. Nine patients (19%) died in the ICU. The 1-year mortality rate was 40%. Among the variables recorded at ICU admission, age > 65 years (p = 0.002), SAPS II score > 32 (p = 0.012), use of LTOT (p = 0.047), and intubation (p = 0.027) were associated with reduced survival in univariate analysis by Cox regression. Multivariate analysis by Cox proportional hazard model showed that age > 65 years (relative risk [RR], 2.70; 95% confidence interval [CI], 1.15 to 6.29) and use of LTOT (RR, 2.52; 95% CI, 1.15 to 5.54) were independently associated with reduced survival.Conclusions: We performed the first study providing information related to the impact of the first ICU stay for RF on long-term outcomes for patients with bilateral bronchiectasis. Age > 65 years and prior use of LTOT were associated with reduced survival.