Koller R, Zöch G, Bayer G S, Agstner I, Andel H, Frey M, Meissl G
Abteilung Wiederherstellungs- und Plastische Chirurgie, Intensivpflege für Brandverletzte, Universitätsklinik für Chirurgie, Wien.
Chirurg. 1999 Aug;70(8):915-22; discussion 921-2. doi: 10.1007/s001040050742.
The present study analyzes the outcome of 51 patients aged more than 65 years, who were admitted between 1993 and 1997 to a specific burns unit with the possibility of intensive care medicine including respirator therapy and hemofiltration. The results were compared to an historical control group treated between 1980 and 1990. The overall survival rate was 54 %. Analyzing the patients' mortality, an increase in the number of nurses, improvement of enteral nutrition and wound monitoring had more influence on the survival rates than respirator therapy, hemofiltration and catecholamines. This is in contrast to our experience with younger individuals. The positive influence of intensive care on survival was restricted only to a small number of cases. The group of patients who died on the intensive care unit showed a relatively long median survival time of 24 days. Septic multiorgan failure was the main cause of death.
本研究分析了1993年至1997年间入住某特定烧伤科的51例65岁以上患者的治疗结果,该科室具备重症监护医学条件,包括呼吸治疗和血液滤过。将结果与1980年至1990年期间治疗的历史对照组进行比较。总体生存率为54%。分析患者死亡率时发现,护士数量增加、肠内营养改善和伤口监测对生存率的影响大于呼吸治疗、血液滤过和儿茶酚胺。这与我们对年轻患者的经验相反。重症监护对生存的积极影响仅限于少数病例。在重症监护病房死亡的患者组中位生存时间相对较长,为24天。感染性多器官功能衰竭是主要死因。