Ambuehl Julia, Karrer Adrienne, Meer Andreas, Riedel Thomas, Schibler Andreas
Paediatric and Neonatal Intensive Care Unit, University Children's Hospital, Inselspital, Bern, Switzerland.
Swiss Med Wkly. 2007 Jun 2;137(21-22):312-6. doi: 10.4414/smw.2007.11469.
The mortality rate in paediatric intensive care units (PICU) has fallen over the last two decades. More advanced treatment is offered to children with life-threatening disease and there is substantial interest in knowing whether long term outcome and quality of life after intensive care are acceptable.
12-bed paediatric and neonatal intensive care unit.
Prospective follow-up study with telephone interview 1 and 2 years after discharge.
Four domains of quality of life (physical function, role function, social-emotional function and health problem) were recorded by calculating the health state classification (HSC) index. Outcome was classified good (HSC 1.0-0.7), moderate (HSC 0.69-0.3), poor (HSC 0.29-0) and very poor (HSC <0).
661 patients were admitted to the PICU in the year 2001 with a mortality within the unit of 3.9%. Over 2 years follow-up there were 21 additional deaths (3.2%). 574 patients could be followed up after 1 year and 464 patients after 2 years. After two years the outcome was good in 77%, moderate in 15% and poor in 8%. Patients with respiratory disease had the best outcome, similar to those admitted for neurological and medical reasons. Patients admitted for postoperative care and for cardiovascular disease had a poorer quality of life. 31% of the children had preexisting health care problems and 21% of all patients had new chronic disease after intensive care.
The majority of survivors admitted to the PICU have a good outcome. The overall mortality rate doubled if assessed two years after discharge.
在过去二十年中，儿科重症监护病房（PICU）的死亡率有所下降。对于患有危及生命疾病的儿童，提供了更先进的治疗方法，人们对了解重症监护后的长期预后和生活质量是否可以接受有着浓厚的兴趣。
拥有12张床位的儿科和新生儿重症监护病房。
出院后1年和2年进行电话访谈的前瞻性随访研究。
通过计算健康状态分类（HSC）指数记录生活质量的四个领域（身体功能、角色功能、社会情感功能和健康问题）。结果分为良好（HSC 1.0 - 0.7）、中等（HSC 0.69 - 0.3）、差（HSC 0.29 - 0）和非常差（HSC <0）。
2001年有661名患者入住PICU，该病房内的死亡率为3.9%。在2年的随访中，又有21人死亡（3.2%）。1年后可对574名患者进行随访，2年后可对464名患者进行随访。两年后，77%的患者结果良好，15%为中等，8%为差。患有呼吸系统疾病的患者预后最好，与因神经和医疗原因入院的患者相似。因术后护理和心血管疾病入院的患者生活质量较差。31%的儿童有既往医疗问题，21%的所有患者在重症监护后出现新的慢性病。
入住PICU的大多数幸存者预后良好。如果在出院两年后进行评估，总体死亡率会翻倍。
