在重症监护室的妄想和长期存活率:一个回顾性研究
Ignazio De Trizio1, Maria Angeliki Komninou1, Jutta Ernst2
1Institute for Intensive Care Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
BMC neurology
|January 15, 2025
概括
重症监护室 (ICU) 的妄想独立减少长期存活率. 患有ICU狂妄症的患者,尤其是55岁以上的患者,在出院后长达四年的生存率明显降低.
科学领域:
- 临界护理医学 临界护理医学
- 重症监护病房 (ICU) 研究研究
- 长期患者的结果.
背景情况:
- 狂妄症是重症监护室 (ICU) 的常见并发症.
- 重症监护室痴呆症与更长的住院时间,增加的发病率和不清楚的长期生存影响有关.
- 了解ICU痴呆症对长期生存的影响至关重要.
研究的目的:
- 调查ICU痴呆症与长期生存之间的独立关联.
- 分析患有 Delirium 和没有 Delirium 的患者在 ICU 退院后长达四年的生存率.
- 检查年龄对ICU痴呆症和长期存活率之间的关系的影响.
主要方法:
- 在一个单一中心进行了四年的回顾性观察性研究,涉及成年ICU幸存者.
- 用密集护理 Delirium 查清单 (ICDSC) 和 ICD-10 代码 F05.05 识别的 ICU 痴呆症.
- 生存分析采用卡普兰-梅尔曲线,绝对风险差异和多变量逻辑回归,并按年龄分组分析.
主要成果:
- 在9604名ICU幸存者中,有22.6%患有妄想症.
- 强症监护室妄与显著降低的长期存活率独立相关 (p < 0.0001,ARD = 11.8%).
- 在55-64岁 (p < 0.001,ARD = 7.3%) 和≥65岁 (p < 0.0001,ARD = 11.1%) 的患者中,减少的生存率尤为明显.
结论:
- 病房狂妄是减少长期存活率的独立预测因素.
- 强症监护室狂妄症和降低生存率之间的关联在55岁以上的患者中尤为明显.
- 这些发现凸显了治疗ICU患者的痴呆症至关重要,以改善长期结果.
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