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芬兰老年人的重症监护。

Intensive care of the elderly in Finland.

作者信息

Reinikainen M, Uusaro A, Niskanen M, Ruokonen E

机构信息

Department of Intensive Care, North Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland.

出版信息

Acta Anaesthesiol Scand. 2007 May;51(5):522-9. doi: 10.1111/j.1399-6576.2007.01274.x.

Abstract

BACKGROUND

The ageing of the population will increase the demand for health care resources. The aim of this study was to determine how age affects resource consumption and outcome of intensive care in Finland.

METHODS

Data on 79,361 admissions to 26 Finnish intensive care units (ICUs) during the years 1998-2004 were analysed. The severity of illness was measured using Simplified Acute Physiology II scores and the intensity of care using Therapeutic Intervention Scoring System scores.

RESULTS

The median age was 62 years; 8.9% of patients were aged 80 years or over. The hospital mortality rate was 16.2% in the overall patient population, but 28.4% in patients aged 80 years or over. Old age was an independent risk factor for hospital mortality. The mean intensity of care was at its highest in the age groups 60-69, 70-74 and 75-79 years. It was notably lower for patients aged 80 years or over. If the need for intensive care remains unchanged in each age group, the change in the age distribution of the Finnish population will increase the demand for ICU beds by 19% by the year 2020 and by 25% by the year 2030.

CONCLUSION

The hospital mortality rate increases with increasing age. The mean intensity of care is lower for the oldest patients than for patients aged less than 80 years. The ageing of the population will probably cause a remarkable increase in the need for intensive care in the near future.

摘要

背景

人口老龄化将增加对医疗保健资源的需求。本研究的目的是确定年龄如何影响芬兰重症监护的资源消耗和结局。

方法

分析了1998年至2004年期间芬兰26个重症监护病房(ICU)的79361例入院患者的数据。使用简化急性生理学II评分来衡量疾病严重程度,使用治疗干预评分系统评分来衡量护理强度。

结果

中位年龄为62岁;8.9%的患者年龄在80岁及以上。总体患者人群的医院死亡率为16.2%,但80岁及以上患者的死亡率为28.4%。高龄是医院死亡的独立危险因素。护理强度均值在60 - 69岁、70 - 74岁和75 - 79岁年龄组中最高。80岁及以上患者的护理强度明显较低。如果每个年龄组对重症监护的需求保持不变,芬兰人口年龄分布的变化将使到2020年ICU床位需求增加19%,到2030年增加25%。

结论

医院死亡率随年龄增长而增加。年龄最大的患者的护理强度均值低于80岁以下患者。人口老龄化可能在不久的将来导致对重症监护需求的显著增加。

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