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[入住重症监护病房的系统性风湿性疾病患者的结局:39例回顾性研究]

[Outcome of patients with systemic rheumatic diseases admitted to intensive care units: a retrospective study of 39 cases].

作者信息

Pourrat O, Bureau J M, Hira M, Martin-Barbaz F, Descamps J M, Robert R

机构信息

Service de Réanimation Médicale et Médecine Interne, Urgences, Hôpital Jean-Bernard, CHU, Poitiers, France.

出版信息

Rev Med Interne. 2000 Feb;21(2):147-51. doi: 10.1016/s0248-8663(00)88243-0.

Abstract

PURPOSE

Patients with systemic rheumatic diseases are rarely admitted in intensive care units and very few studies focusing on the prognosis of those patients have been published.

METHODS

Retrospective study over seven years in two intensive care units.

RESULTS

Among 33 patients with systemic disease diagnosed 90 +/- 133 months before admission in the intensive care unit, who were aged 50 +/- 21 years and represented a total of 39 stays in the intensive care unit, the main cause of admission was acute respiratory failure (33%). Mean simplified acute physiology score (SAPS II) was 47 +/- 22. Two-thirds of the patients were under mechanical ventilation. Infection was diagnosed in 33% of the cases and exacerbation of the systemic rheumatic disease in 26%. Nosocomial infection was found in 19 patients (49%). Ten patients died during their stay in the intensive care unit, six from infection, three from an exacerbation of the systemic rheumatic disease, one from an unidentified cause.

CONCLUSION

Even if severity scores of patients suffering from systemic diseases are higher at admission in intensive care units than those of other patients, there is no relevant reason to refuse critical care to these patients.

摘要

目的

患有全身性风湿性疾病的患者很少入住重症监护病房,且很少有关于这些患者预后的研究发表。

方法

对两个重症监护病房进行为期七年的回顾性研究。

结果

在入住重症监护病房前90±133个月被诊断患有全身性疾病的33例患者中,年龄为50±21岁,共入住重症监护病房39次,主要入院原因是急性呼吸衰竭(33%)。简化急性生理学评分(SAPS II)平均为47±22。三分之二的患者接受机械通气。33%的病例诊断为感染,26%为全身性风湿性疾病加重。19例患者(49%)发生医院感染。10例患者在重症监护病房住院期间死亡,6例死于感染,3例死于全身性风湿性疾病加重,1例死因不明。

结论

即使患有全身性疾病的患者在入住重症监护病房时的严重程度评分高于其他患者,但没有合理理由拒绝为这些患者提供重症监护。

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