Department of Anaesthesiology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
J Crit Care. 2011 Aug;26(4):379-87. doi: 10.1016/j.jcrc.2010.11.004. Epub 2011 Mar 3.
The purpose of the study was to assess long-term mortality after an intensive care unit (ICU) stay and to test the hypotheses that (1) quality of life improves over time and (2) predictions of outcome made by caregivers during an ICU stay are reliable.
Data from a 6-bed university medical ICU were reviewed. Telephone assessment of mortality and interviews/questionnaires 9 years after an ICU stay were performed. Comparison of caregivers' predictions of survival/quality of life with reported outcome was done.
Of 409 patients surviving 6 months after ICU, 334 were included and 146 of these had died. Age, diagnostic group, and severity of illness were significant factors for mortality (P < .0001 for all 3). Of all survivors, 59% described their overall quality of life as good and 35% as fair. Physical dependency was significantly related to length of hospital stay (P < .01), whereas quality of life was related to admission age (P < .05). Caregivers' predictions concerning both survival and quality of life seemed reliable, with physicians' predictions being more reliable than nurses' (P < .05).
Mortality is high 9 years after ICU stay. Quality of life may deteriorate for some individuals; however, overall quality of life for most survivors remains acceptable and may even improve. Long-term outcome predictions made by caregivers during the ICU stay seem accurate.
本研究旨在评估重症监护病房(ICU)住院后的长期死亡率,并验证以下两个假设:(1)患者的生活质量随时间推移而改善;(2)在 ICU 住院期间医护人员的预后预测是可靠的。
回顾了一所 6 床的大学附属医院 ICU 的数据。通过电话评估患者的死亡率,并在 ICU 住院 9 年后进行访谈/问卷调查。将医护人员对生存/生活质量的预测与实际结果进行比较。
在 ICU 存活 6 个月的 409 名患者中,有 334 名患者被纳入研究,其中 146 名患者已经死亡。年龄、诊断分组和疾病严重程度是死亡率的显著影响因素(所有 3 项 P 值均<.0001)。在所有幸存者中,59%的患者总体生活质量良好,35%的患者生活质量一般。身体依赖与住院时间显著相关(P<.01),而生活质量与入院年龄相关(P<.05)。医护人员对生存和生活质量的预测似乎是可靠的,医生的预测比护士的预测更可靠(P<.05)。
在 ICU 住院 9 年后,死亡率仍然较高。一些患者的生活质量可能会恶化,但大多数幸存者的整体生活质量仍然可以接受,甚至可能会有所改善。在 ICU 住院期间医护人员的预后预测似乎是准确的。