在老年人中,限制症状和严重疾病后的残疾之间存在关联
Snigdha Jain1, Ling Han1, Evelyne A Gahbauer1
1Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Critical care medicine
|September 19, 2024
概括
在重症监护室 (ICU) 住院后幸存下来,症状限制活动的老年人经历了显著更多的残疾. 管理这些症状可以改善老年ICU幸存者的功能恢复.
科学领域:
- 老年学是一门学科.
- 关键护理医学 关键护理医学
- 康复科学 康复科学 康复科学
背景情况:
- 经过重症生存的老年人面临着增加的残疾,影响独立性和生活质量.
- 识别导致重症监护室 (ICU) 后残疾的因素对于改善患者的治疗结果至关重要.
研究的目的:
- 评估活动限制症状与老年人急诊室住院后残疾增加之间的关联.
- 确定限制性症状的数量或存在是否预示着更大的功能障碍.
主要方法:
- 展望纵向研究,涉及70岁及以上的社区成年人.
- 每月采访评估限制症状和残疾 (ADLs,IADLs,移动性) 在ICU出院后的6个月内.
- 多变量波松回归模型根据ICU前的残疾,虚弱,认知障碍,机械呼吸和ICU停留时间进行调整.
主要成果:
- 每个额外的限制性症状都与5%的残疾增加有关 (aRR,1.05;95% CI,1.04-1.06).
- 经历两个或两个以上的限制性症状与29%更多的残疾相关 (aRR,1.29;95% CI,1.22-1.36).
- 在调整已知的风险因素后,这些关联仍然很重要.
结论:
- 活动限制症状独立地与老年ICU幸存者的残疾增加有关.
- 准和管理这些症状可能是提高功能恢复的关键策略.
- 这些发现强调了症状管理在老年患者的ICU后护理中的重要性.
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