在严重败血症的幸存者中长期认知障碍和功能障碍
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
概括
严重的败血症显著增加了老年人的认知障碍和功能障碍,导致持续的限制. 这些缺陷极大地影响了幸存者独立生活的能力.
科学领域:
- 老年学是一门学科.
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 认知障碍和功能障碍是护理需求和医疗保健成本的关键驱动因素.
- 严重败血症的长期认知和功能后果尚不清楚.
研究的目的:
- 评估严重败血症后认知功能和身体能力的变化.
- 为了将这些变化与非败血症住院后的变化进行比较,并根据先前存在的条件进行调整.
主要方法:
- 使用健康和退休研究数据 (1998-2006) 的前性队列研究.
- 包括516名严重败血症幸存者和4517名非败血症住院幸存者,基线和后续评估.
- 通过采访评估认知障碍和日常生活活动 (ADL/IADL).
主要成果:
- 严重败血症的幸存者在中度至严重的认知障碍中增加了10.6% (OR 3.34).
- 新的功能限制在没有先前限制的人中平均为1.57,在轻度/中度限制的人中平均为1.50.
- 这些下降持续了至少8年,并且明显大于非败血症住院患者.
结论:
- 严重的败血症独立地与老年人显著,持续的认知和功能衰退有关.
- 这些缺口大大削弱了幸存者的独立性,增加了护理需求.
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