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持久性危急疾病的长期结果

Louisa W J He¹, Ary Serpa Neto², Alisa M Higgins³

¹Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia.

Annals of the American Thoracic Society

|August 14, 2025

概括

持久性严重疾病 (PerCI) 患者在ICU后面临更高的死亡或残疾风险. 幸存者在三到六个月之间表现出显著的功能恢复,表明改善的潜力.

科学领域:

关键护理医学关键护理医学
重症监护室 (ICU) 的结果
长期患者康复长期患者康复

背景情况:

持续性严重疾病 (PerCI) 影响着越来越多的长期严重疾病的ICU患者.
这些患者消耗了大量的医疗保健资源,但长期的功能结果仍然不太清楚.
了解PerCI的结果对于资源配置和患者护理规划至关重要.

研究的目的:

为了比较六个月后在ICU患者中与没有PerCI的死亡或新增残疾的发生率.
将PerCI定义为在ICU中持续至少10天的严重疾病.
评估重症患者的长期功能结果和康复轨迹.

主要方法:

一项多中心前性队列研究的二次分析,涉及24小时以上的机械通风成年人.
主要结局: ICU 后六个月死亡或新的残疾 (WHODAS 2.0 增加≥10%).
二次结局包括生活质量,认知和心理健康在3个月和6个月,显著程度为0.01.

主要成果:

主要结局 (死亡或新的残疾) 发生在72.5%的PerCI患者中,而对照组为53.9% (调整后风险差异为10.70%).
六个月后的死亡率在PerCI组 (30.2%) 与对照组 (10.4%) 相比显著更高 (p<0.001).
在幸存者中,在50.5%的PerCI患者中观察到新的残疾,而对照组为32.2%,在三到六个月之间注意到显著恢复.

结论:

患有持久性危急疾病的患者在ICU后六个月经历更高的死亡或新的残疾发病率.
在三到六个月的PerCI幸存者中观察到功能结果的显著恢复.
进一步的研究应该集中在改善PerCI患者长期结果的干预措施上.

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