在日本,对老年ICU患者进行生命维持干预的利用和结果:全国性的注册研究
Junji Shiotsuka1, Tomoyuki Masuyama2, Shigehiko Uchino3
1Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Tochigi, Japan.
Intensive care medicine
|January 8, 2025
概括
在日本ICU的老年患者接受了更少的生命支持干预,但仍然有显著的死亡率和不良的回家率. 这凸显了老年重症监护患者的复杂护理决策.
科学领域:
- 关键护理医学 关键护理医学
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 重症监护室 (ICU) 为重症患者提供支持生命的干预措施.
- 老年人代表了在重症监护机构中日益增长的人口.
- 了解老年ICU患者的干预模式和结果对于资源配置和护理质量至关重要.
研究的目的:
- 描述在接受日本ICU治疗的老年患者中使用维持生命的干预措施.
- 分析这些老年患者的短期结果,包括死亡率和回家率.
主要方法:
- 从2015年4月至2022年3月期间的日本重症监护患者数据库 (JIPAD) 的数据分析.
- 包括所有成年ICU患者,分层分为年龄组.
- 评估机械通风,连续脏替代疗法和体外膜氧化的复合使用.
主要成果:
- 分析了超过233,000名患者;18.2%的患者在80多岁,2.3%的患者在90多岁,67%的患者在100多岁.
- 生命维持干预措施,包括机械通风和体外膜氧化,随着年龄的增长而减少 (例如,在18-59岁的人群中减少了40.4%,而在90-99岁的人群中减少了27.6%).
- 80岁以上的ICU患者的死亡率为5.6%,医院死亡率为12.9%,大约50-60%的老年患者没有回家.
结论:
- 在日本,对老年ICU患者提供生命支持干预的频率较低.
- 尽管干预率有所下降,但仍有大量的老年患者接受了密集治疗.
- 老年ICU患者的结果,包括死亡率和功能恢复 (回家),仍然是一个重大问题.
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