狂妄症は,重症病棟の機械呼吸器患者の死亡率の予測因子である
E Wesley Ely1, Ayumi Shintani, Brenda Truman
1Department of Medicine, Division of General Internal Medicine and Center for Health Services Research and the Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, Nashville, Tenn, USA.
JAMA
|April 15, 2004
まとめ
集中治療室 (ICU) での妄想症は,機械呼吸器を受給している患者が独立して,より悪い結果を予測します. これには,6ヶ月の死亡率の増加とより長い入院期間が含まれ,この一般的な状態に対処することの重要性を強調しています.
科学分野:
- クリティカルケア・メディシン
- 神経科学は神経科学である.
- ゲリアトリクス ゲリアトリクス
背景:
- 妄想は,集中治療室 (ICU) で頻繁に発生する,しかししばしば認識されない合併症です.
- 患者の予後,特に機械呼吸器を使用している患者の予後に対するその影響は,まだ完全に理解されていません.
研究 の 目的:
- 妄想が機械呼吸器のICU患者の臨床結果を独立して予測するかどうかを調査する.
- 具体的には,6ヶ月の死亡率と入院期間との関連を調査した.
主な方法:
- 大学にある医療センターで機械呼吸器を施した患者275人を対象とした前向きなコホート研究.
- 妄想はICUとリッチモンド興奮鎮静スケールの混乱評価方法を使用して監視されました.
- アウトカムには,6ヶ月の死亡率,入院期間,ICU後の入院が含まれていました.
主要な成果:
- 224人の適格な患者のうち,81.7%が妄想を発症した.
- 妄想症は,6ヶ月の死亡率 (34%対15%) とより長い入院期間 (10日以上) と関連していました.
- 共同変数を調整した後に,妄想は独立して6ヶ月の死亡率増加 (aHR 3.2) とより長い入院期間 (aHR 2.0) を予測した.
結論:
- 妄想は,機械呼吸器のICU患者における有害な結果の独立した予測因子である.
- これは,6ヶ月の死亡率の増加と長期の入院と有意に関連しています.
- 発見は,この脆弱な患者集団における妄想の臨床的重要性を強調しています.
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