慢性認知障害と機能障害は,重症性セプシスの生存者の間で認められている
Theodore J Iwashyna1, E Wesley Ely, Dylan M Smith
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA. tiwashyn@umich.edu
JAMA
|October 28, 2010
まとめ
重度のセプシスは,高齢者の認知障害と機能障害を大幅に増加させ,持続的な制限につながります. これらの欠陥は,生存者が独立して生活する能力に深刻に影響を与えます.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- クリティカルケア・メディシン
- エピデミオロジー エピデミオロジー
背景:
- 認知障害と機能障害は,ケアニーズと医療費の主要な要因です.
- 重度のセプシスの長期的認知および機能的影響は十分に理解されていません.
研究 の 目的:
- 重度のセプシス後の認知機能と身体能力の変化を評価する.
- これらの変化をセプシス以外の入院後の変化と比較し,既存の状態を調整する.
主な方法:
- 健康と退職研究 (1998年−2006年) のデータを用いた前向きなコホート研究.
- 516人の重症性セプシス生存者と,4517人の非セプシス性入院生存者を含め,ベースラインとフォローアップの評価を行った.
- 面接を通じて認知障害と日常生活活動 (ADL/IADL) を評価した.
主要な成果:
- 重度のセプシス生存者は,中等から重度の認知障害の10.6%の増加を経験しました (OR 3.34).
- 新しい機能的制限の平均値は,以前の制限がない人の場合1.57で,軽度/中等度の制限を持つ人の場合1.50でした.
- これらの減少は少なくとも8年間持続し,セプシス以外の入院患者よりも著しく増加しました.
結論:
- 重度のセプシスは,高齢者の有意で持続的な認知機能低下と独立して関連しています.
- これらの赤字は,生存者の独立性を大幅に損なっており,介護の必要性を高めています.
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