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重症监护病房出院18个月后危重症幸存者的生活质量结果

Quality of life outcome of critical care survivors eighteen months after discharge from intensive care.

作者信息

Fildissis George, Zidianakis Vasilios, Tsigou Efi, Koulenti Despina, Katostaras Theofanis, Economou Aikaterini, Baltopoulos George

机构信息

Athens University, Faculty of Nursing, ICU at KAT General Hospital, Nikis 2, 14561, Kifissia, Athens, Greece.

出版信息

Croat Med J. 2007 Dec;48(6):814-21. doi: 10.3325/cmj.2007.6.814.

Abstract

AIM

To assess the changes in health-related quality of life in patients discharged from the intensive care unit (ICU).

METHODS

At the General University ICU, Trauma Hospital in Athens, 242 patients were enrolled prospectively over a study period of 18 months. Out of these, 116 participants (47.9%) completed all survey components at 6, 12, and 18 months. We used Quality of Life-Spanish (QOL-SP) to assess the health-related quality of life. Patients or their relatives were interviewed on ICU admission and at 6, 12, and 18 months after discharge from the ICU.

RESULTS

Mean quality of life score of the patients increased from 2.9+/-4.8 (out of maximum 25 points) on ICU admission to 7.0+/-7.2 points at 6 months after discharge, and then decreased to 5.6+/-6.9 points at 18 months (P<0.001; Friedman Test). Multilinear regression analysis showed that the variables which had the strongest association with the quality of life on admission were age (P=0.002) and male sex (P=0.001), whereas age (P<0.001), length of ICU stay (P<0.001), and male sex (P=0.002) had the strongest association 18 months after discharge from the ICU. Survival rate was 66.9% at discharge from ICU and 61.6% at hospital discharge. There were 33% deaths in the ICU, 5.3% in the hospital, and 6.2% after ICU discharge. There were 7.4% patients lost to follow-up.

CONCLUSIONS

After discharge from the ICU, patients' quality of life was poor and showed an improvement at 18 months after discharge, but was still worse than on admission. Age, ICU length of stay, and male sex were the factors that had the strongest impact on the quality of life on admission and at 18 months after discharge from the ICU.

摘要

目的

评估重症监护病房(ICU)出院患者健康相关生活质量的变化。

方法

在雅典创伤医院的综合大学ICU,在18个月的研究期间前瞻性纳入了242例患者。其中,116名参与者(47.9%)在6个月、12个月和18个月时完成了所有调查项目。我们使用西班牙语生活质量量表(QOL-SP)来评估健康相关生活质量。在患者入住ICU时以及从ICU出院后的6个月、12个月和18个月对患者或其亲属进行访谈。

结果

患者的平均生活质量评分从入住ICU时的2.9±4.8(满分25分)增加到出院后6个月时的7.0±7.2分,然后在18个月时降至5.6±6.9分(P<0.001;Friedman检验)。多线性回归分析显示,入院时与生活质量关联最强的变量是年龄(P=0.002)和男性(P=0.001),而在从ICU出院18个月后,年龄(P<0.001)、ICU住院时间(P<0.001)和男性(P=0.002)与生活质量关联最强。ICU出院时的生存率为66.9%,出院时的生存率为61.6%。在ICU死亡的患者占33%,在医院死亡的患者占5.3%,在ICU出院后死亡的患者占6.2%。有7.4%的患者失访。

结论

从ICU出院后,患者的生活质量较差,出院18个月后有所改善,但仍比入院时差。年龄、ICU住院时间和男性是对入院时以及从ICU出院18个月后的生活质量影响最大的因素。

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