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长期重症监护后的生活质量。

Quality of life after prolonged intensive care.

作者信息

Niskanen M, Ruokonen E, Takala J, Rissanen P, Kari A

机构信息

Critical Care Research Program, the Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Finland.

出版信息

Crit Care Med. 1999 Jun;27(6):1132-9. doi: 10.1097/00003246-199906000-00035.

Abstract

OBJECTIVE

To assess the subjective health status, quality of life, and functional ability of patients whose intensive care stay was prolonged and to compare their quality of life with that of the general population.

DESIGN

Inception cohort study.

SETTING

Twenty-three-bed multidisciplinary intensive care unit (ICU) in a tertiary care center.

PATIENTS

A consecutive sample of 718 patients aged > or = 18 yrs who required intensive care > or = 4 days.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The Nottingham Health Profile was used to compare the ICU patients with a random sample (n = 2,595) of the general population. The quality of life and functional ability of 368 respondents (78.3% of 470 survivors) were assessed at 6 months after ICU admission. The length of the ICU stay was 13.6+/-11.8 (median, 9; maximum, 81) days. The quality of life and its various dimensions were influenced by the diagnosis for ICU admission and age. Although problems in physical mobility and energy were prevalent among all patient groups, only a small proportion was dependent on others for the management of daily activities. Patients with trauma or respiratory failure experienced the most limitations. The quality of life of elderly patients and patients who had undergone cardiac surgery was comparable with the general population regarding emotional reactions, social isolation, and pain.

CONCLUSIONS

The quality of life of survivors after a prolonged intensive care stay is fairly good, although not comparable with that of the general population. The psychosocial aspects of the quality of life are restored more rapidly than physical performance.

摘要

目的

评估重症监护停留时间延长的患者的主观健康状况、生活质量和功能能力,并将他们的生活质量与普通人群进行比较。

设计

队列起始研究。

地点

一家三级医疗中心的拥有23张床位的多学科重症监护病房(ICU)。

患者

连续抽取的718名年龄≥18岁且需要重症监护≥4天的患者。

干预措施

无。

测量指标及主要结果

使用诺丁汉健康量表将ICU患者与普通人群的随机样本(n = 2595)进行比较。在ICU入院6个月后评估了368名受访者(470名幸存者中的78.3%)的生活质量和功能能力。ICU停留时间为13.6±11.8(中位数为9;最大值为81)天。生活质量及其各个维度受到ICU入院诊断和年龄的影响。尽管身体活动和精力方面的问题在所有患者组中都很普遍,但只有一小部分人在日常生活管理上依赖他人。创伤或呼吸衰竭患者经历的限制最多。老年患者和接受心脏手术的患者在情绪反应、社会隔离和疼痛方面的生活质量与普通人群相当。

结论

重症监护停留时间延长后的幸存者生活质量相当不错,尽管与普通人群的生活质量不可比。生活质量的心理社会方面比身体表现恢复得更快。

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