集中治療室で生き延びたメディケア受給者の3年間の成果
Hannah Wunsch1, Carmen Guerra, Amber E Barnato
1Department of Anesthesiology, Columbia University, 622 W 168th St, PH-527D, New York, NY 10032, USA. hw2125@columbia.edu
JAMA
|March 4, 2010
まとめ
集中治療室で生存している高齢患者は,一般的または入院した対照群よりも3年後の死亡率が高くなります. 機械的な換気は,特に放出後の最初の6ヶ月間に,このリスクを大幅に増加させます.
科学分野:
- クリティカルケア・メディシン
- ゲリアトリック・メディシン (老年医学)
- 公衆衛生は公衆衛生である.
背景:
- 集中治療室 (ICU) の患者の病院での死亡率は減少しています.
- ICUの生存者の長期的な結果はよく理解されていません.
研究 の 目的:
- 集中治療室で生存するメディケア受給者の3年生存率と結果を評価する.
主な方法:
- 65歳以上のメディケア受給者の遡及的なコホート研究.
- マッチングされた対照群には,入院患者と一般人口が含まれていた.
- 病院退院後の3年間の追跡調査.
主要な成果:
- ICUの生存者は,病院 (34.5%) と一般的な (14.9%) コントロールと比較して,3年後の死亡率が高かった (39.5%).
- 機械的な換気は,死亡リスクを大幅に増加させた (57.6%対32.8%対照群).
- 熟練した介護施設への退院は,6ヶ月の死亡率の上昇と関連していました.
結論:
- 集中治療室で生存している高齢者の多くは,長期的に高い死亡率に直面しています.
- 機械的換気は,ICU後の死亡率の増加を促す重要な要因です.
- 退院後の早い時期は,高リスクのICU生存者にとって非常に重要です.
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