Wilson M T, Crawford K L, Shabot M M
Burns and Allen Research Institute, Los Angeles, California, USA.
Am Surg. 2000 Sep;66(9):870-3.
This study compared the severity of illness and outcomes of surgical intensive care unit (SICU) patients age 100 years or older with those of younger SICU patients. Severity of illness was measured with the Simplified Acute Physiology Score (SAPS) and the Quantified Therapeutic Intervention Scoring System (QTISS). Outcomes were evaluated with SICU length of stay (LOS), hospital LOS, SICU mortality, and hospital mortality. All patients admitted to an urban, tertiary-care SICU from August 1, 1986 to July 31, 1998 (12 years) were included. A total of 24,395 consecutive patients were evaluated of whom nine (0.037%) were age 100 or more. Complete outcome data were available for 13,773 patients who were divided into five groups on the basis of age: <70, 70 to 79, 80 to 89, 90 to 99, and 100 years and above. Nine centenarians were admitted to the SICU of whom one died in the SICU and another died in the hospital after SICU discharge (22.2% overall mortality). Centenarian patients had higher SAPS and QTISS on admission than patients in all other groups, although this difference was not significant because of the small number of centenarians. SICU and hospital LOS were not significantly longer for centenarians. Mortality in the SICU and hospital was significantly different across the age groups and rose with age. However, the modest 11.1 per cent SICU mortality rate in centenarians along with their LOS statistics indicate that these patients fare relatively well in surgical intensive care.
本研究比较了100岁及以上外科重症监护病房（SICU）患者与年轻SICU患者的疾病严重程度和预后。采用简化急性生理学评分（SAPS）和量化治疗干预评分系统（QTISS）来衡量疾病严重程度。通过SICU住院时间（LOS）、医院住院时间、SICU死亡率和医院死亡率来评估预后。纳入了1986年8月1日至1998年7月31日（12年）期间入住城市三级护理SICU的所有患者。总共对24395例连续患者进行了评估，其中9例（0.037%）年龄在100岁及以上。13773例患者有完整的预后数据，这些患者根据年龄分为五组：<70岁、70至79岁、80至89岁、90至99岁以及100岁及以上。9例百岁老人入住了SICU，其中1例在SICU死亡，另1例在SICU出院后在医院死亡（总死亡率为22.2%）。尽管由于百岁老人数量较少，差异不显著，但百岁老人入院时的SAPS和QTISS高于所有其他组的患者。百岁老人的SICU和医院住院时间并没有显著延长。不同年龄组的SICU和医院死亡率存在显著差异，且随年龄增长而上升。然而，百岁老人11.1%的适度SICU死亡率及其住院时间统计数据表明，这些患者在外科重症监护中情况相对较好。
