Welsh C H, Thompson K, Long-Krug S
Department of Medicine, Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center, USA.
Crit Care Med. 1999 Aug;27(8):1466-71. doi: 10.1097/00003246-199908000-00011.
Baseline patient functional status as assessed by providers is correlated with mortality after intensive care unit (ICU) admission. We wanted to see if patient self-perception of health status before admission to an ICU correlated with functional outcome.
Prospective survey on a convenience sample.
Single urban university-affiliated Veterans Affairs Medial Center.
One hundred ninety-nine patients in surgical and medical/coronary ICUs.
None.
Patient-assessed baseline health status was monitored with the Medical Outcome Survey Short-Form 36 (SF-36), consisting of 36 questions that evaluate eight health status concepts. In addition, baseline functional status (Zubrod scale) was determined and severity of illness (Acute Physiology and Chronic Health Evaluation [APACHE] II) data were collected. Zubrod functional status, which includes mortality, was determined 6 wks and 6 months after ICU admission, and correlation coefficients were calculated.
We found it feasible to collect SF-36 health status data on a 9% sample in this setting. Less than 1% of responses were completed by proxy. The SF-36 data were internally consistent, and several of its scales including general health perception and physical functioning correlated with patient Zubrod functional status (r2 = .08, p < .001; r2 = .14, p < .001) at 6 wks as did vitality (r2 = .04, p < .01), social function (r2 = .03, p < .05), and physical role function (r2 = .02, p = .053), although to a lesser extent. Similar correlations were also found with 6-month functional status.
We conclude that use of the SF-36 is time efficient in an ICU setting and correlates with 6-wk and 6-month functional outcome. It correlates as well with functional outcome as either the baseline Zubrod functional status or the APACHE II severity of illness measurement. The five-question general health evaluation portion correlated almost as well with outcome as the more extensive 36-item questionnaire. Use of the SF-36 may define patient populations for comparison across hospitals. It may also target individuals with needs for additional posthospitalization care, including rehabilitation services or nursing home placement.
由医疗服务提供者评估的患者基线功能状态与重症监护病房（ICU）入院后的死亡率相关。我们想了解患者在入住ICU之前对健康状况的自我认知是否与功能转归相关。
对便利样本进行前瞻性调查。
一所城市大学附属的退伍军人事务医疗中心。
外科和内科/冠心病ICU的199名患者。
无。
采用医学结局研究简表36（SF - 36）监测患者自我评估的基线健康状况，该量表由36个问题组成，用于评估八个健康状况概念。此外，确定基线功能状态（Zubrod量表）并收集疾病严重程度（急性生理与慢性健康状况评估[APACHE] II）数据。在ICU入院后6周和6个月确定Zubrod功能状态（包括死亡率），并计算相关系数。
我们发现在这种情况下，对9%的样本收集SF - 36健康状况数据是可行的。不到1%的问卷由他人代答。SF - 36数据在内部是一致的，其几个量表，包括总体健康感知和身体功能，在6周时与患者的Zubrod功能状态相关（r2 = .08，p < .001；r2 = .14，p < .001），活力（r2 = .04，p < .01）、社会功能（r2 = .03，p < .05）和身体角色功能（r2 = .02，p = .053）也相关，尽管程度较小。在6个月功能状态方面也发现了类似的相关性。
我们得出结论，在ICU环境中使用SF - 36效率高，且与6周和6个月的功能转归相关。它与功能转归的相关性与基线Zubrod功能状态或APACHE II疾病严重程度测量相同。五题的总体健康评估部分与结果的相关性几乎与更详尽的36项问卷相同。使用SF - 36可以界定用于不同医院间比较的患者群体。它还可以针对那些需要额外出院后护理的个体，包括康复服务或养老院安置。
