预计死亡率高的重症患者:发病率和结果
André Oliveira1, Tatiana Vieira2, Ana Rodrigues3
1Intensive Care Medicine Department, Hospital de Vila Franca de Xira, Estrada Carlos Lima Costa Nº2, 2600-009 Vila Franca de Xira, Portugal.
Medicina intensiva
|November 20, 2023
概括
在重症监护室 (ICU) 预测死亡风险高的患者观察到的死亡率较低. 尽管最初的高风险得分很高,但30%的这些患者存活了一年,这表明预后比预期更好.
科学领域:
- 关键护理医学 关键护理医学
- 预测研究 预测研究
- 健康 结果 研究 研究 结果
背景情况:
- 有相当数量的重症监护病房 (ICU) 患者,根据严重程度得分预测死亡风险非常高.
- 这种高风险的ICU人群的预后和临床结果仍然不明朗,研究不足.
研究的目的:
- 调查重症病患者的实际结果和存活率,确定在ICU入院时死亡风险高.
- 将高风险ICU患者的观察到的死亡率和长期存活率与一般ICU患者进行比较.
主要方法:
- 一项多中心,纵向,观察性队列研究 (CIMbA) 的回顾性分析,涉及16个葡萄牙ICU.
- 纳入标准侧重于简化急性生理学评分II (SAPS II) 预测超过80%的医院死亡率的患者.
- 评估的主要结局包括医院,30天和1年死亡率.
主要成果:
- 12.2%的ICU总人数 (4546名患者) 被归类为高风险患者,预计医院死亡率为89.0±5.8%.
- 这一组的观察到的医院死亡率为61.0%,明显低于预测.
- 高风险患者的30天 (aHR 3.52) 和1年 (aHR 1.14) 死亡率增加,但他们的标准化死亡率与低风险患者 (0.69) 相当.
- 值得注意的是,30%的高风险队列在ICU入院后存活了一年.
结论:
- 大约12%的住院超过24小时的ICU患者的SAPS II分数表明预测死亡风险高于80%.
- 这一高风险组的实际医院标准化死亡率与不太严重的患者的死亡率相似.
- 在这些高风险患者中,很大一部分 (30%) 达到一年的生存率,这表明他们的预后可能比最初的严重程度得分更好.
关键词:
高风险的高风险.在密集的护理中.流行病学 流行病学流行病学 流行病学后续行动 后续行动这是高风险的高风险.重症监护室的重症监护室是重症监护室的重症监护室.死亡率 死亡率死亡率 死亡率 死亡率这是SAPS II.接下来我们就来看一下.更多相关视频
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