感染性休克患者的长期身体转归

Long-term physical outcome in patients with septic shock.

作者信息

Poulsen J B, Møller K, Kehlet H, Perner A

机构信息

Department of intensive Care, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2009 Jul;53(6):724-30. doi: 10.1111/j.1399-6576.2009.01921.x. Epub 2009 Apr 15.

DOI:10.1111/j.1399-6576.2009.01921.x

PMID:19388891

Abstract

BACKGROUND

Limited information is available on physical function after septic shock. The aim of the present study was to assess the physical outcome in survivors 1 year after septic shock.

METHODS

The outcome status of all 174 adult patients admitted to a mixed ICU with the diagnosis septic shock in a 1-year period was registered. Survivors were interviewed about physical function and socioeconomic status using a questionnaire including the Short Form-36 survey. The pre-ICU-admission Functional Comorbidity Index (FCI) was also registered.

RESULTS

Of the 80 survivors, two were still hospitalised; thus, 78 were invited to participate and 70 replied (inclusion-rate 88%). Patients were followed up at median 351 days after hospital discharge. At follow-up the patients had a markedly reduced physical component summary score (PCS) compared with age- and sex-adjusted general population controls (36 vs. 47, P<0.0001). This was also observed in patients with no comorbidity before ICU admission (34 vs. 47, P<0.001). There was a negative correlation (r=-0.27, P=0.03) between pre-ICU-admission FCI values and the PCS at follow-up. According to 81% of the patients, loss of muscle mass was the main cause of decreased physical function. Only 43% (10 vs. 23, P=0.01) of the previously employed had returned to work, and the number of patients in need of home-based personal assistance had doubled (10/20, P=0.04).

CONCLUSION

Physical function is substantially reduced in survivors of septic shock 1 year after discharge.

摘要

背景

关于感染性休克后身体功能的信息有限。本研究的目的是评估感染性休克幸存者1年后的身体状况。

方法

记录了1年内入住综合性重症监护病房（ICU）且诊断为感染性休克的所有174例成年患者的结局状态。使用包括简短健康调查问卷（Short Form-36 survey）在内的问卷对幸存者进行身体功能和社会经济状况访谈。还记录了入住ICU前的功能合并症指数（Functional Comorbidity Index，FCI）。

结果

80名幸存者中，2人仍住院；因此，邀请了78人参与，70人回复（纳入率88%）。患者在出院后中位351天进行随访。随访时，与年龄和性别调整后的普通人群对照组相比，患者的身体成分综合评分（physical component summary score，PCS）显著降低（36 vs. 47，P<0.0001）。在入住ICU前无合并症的患者中也观察到这种情况（34 vs. 47，P<0.001）。入住ICU前的FCI值与随访时的PCS之间存在负相关（r=-0.27，P=0.03）。据81%的患者称，肌肉量减少是身体功能下降的主要原因。以前有工作的患者中只有43%（10 vs. 23，P=0.01）恢复了工作，需要居家个人护理的患者数量增加了一倍（10/20，P=0.04）。