老年危重症患者入住重症监护病房的长期后果：一项纵向研究的设计。

Long-term consequences of an intensive care unit stay in older critically ill patients: design of a longitudinal study.

机构信息

Department of Intensive Care Medicine, Inselspital/Bern University Hospital and University of Bern, Bern, Switzerland.

出版信息

BMC Geriatr. 2011 Sep 2;11:52. doi: 10.1186/1471-2318-11-52.

DOI:10.1186/1471-2318-11-52

PMID:21888641

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3178472/

Abstract

BACKGROUND

Modern methods in intensive care medicine often enable the survival of older critically ill patients. The short-term outcomes for patients treated in intensive care units (ICUs), such as survival to hospital discharge, are well documented. However, relatively little is known about subsequent long-term outcomes. Pain, anxiety and agitation are important stress factors for many critically ill patients. There are very few studies concerned with pain, anxiety and agitation and the consequences in older critically ill patients. The overall aim of this study is to identify how an ICU stay influences an older person's experiences later in life. More specific, this study has the following objectives: (1) to explore the relationship between pain, anxiety and agitation during ICU stays and experiences of the same symptoms in later life; and (2) to explore the associations between pain, anxiety and agitation experienced during ICU stays and their effect on subsequent health-related quality of life, use of the health care system (readmissions, doctor visits, rehabilitation, medication use), living situation, and survival after discharge and at 6 and 12 months of follow-up.

METHODS/DESIGN: A prospective, longitudinal study will be used for this study. A total of 150 older critically ill patients in the ICU will participate (ICU group). Pain, anxiety, agitation, morbidity, mortality, use of the health care system, and health-related quality of life will be measured at 3 intervals after a baseline assessment. Baseline measurements will be taken 48 hours after ICU admission and one week thereafter. Follow-up measurements will take place 6 months and 12 months after discharge from the ICU. To be able to interpret trends in scores on outcome variables in the ICU group, a comparison group of 150 participants, matched by age and gender, recruited from the Swiss population, will be interviewed at the same intervals as the ICU group.

DISCUSSION

Little research has focused on long term consequences after ICU admission in older critically ill patients. The present study is specifically focussing on long term consequences of stress factors experienced during ICU admission.

TRIAL REGISTRATION

ISRCTN52754370.

摘要

背景

现代重症监护医学方法通常使老年重症患者得以存活。重症监护病房（ICU）中患者的短期治疗结果，如存活至出院，已有充分记录。然而，关于后续的长期结果，人们知之甚少。疼痛、焦虑和躁动是许多重症患者的重要应激因素。很少有研究关注重症患者的疼痛、焦虑和躁动及其后果。本研究的总体目标是确定 ICU 入住如何影响老年人以后的生活体验。更具体地说，本研究有以下目标：（1）探讨 ICU 入住期间的疼痛、焦虑和躁动与以后生活中出现相同症状的关系；（2）探讨 ICU 入住期间经历的疼痛、焦虑和躁动与随后的健康相关生活质量、对医疗保健系统的使用（再入院、就诊、康复、药物使用）、生活状况以及出院后和随访 6 个月和 12 个月时的生存情况之间的关联。

方法/设计：本研究将采用前瞻性、纵向研究。总共将有 150 名 ICU 中的老年重症患者参与（ICU 组）。将在 3 个时间点测量疼痛、焦虑、躁动、发病率、死亡率、对医疗保健系统的使用以及健康相关生活质量，基线评估后进行。基线测量将在 ICU 入院后 48 小时和一周后进行。后续测量将在 ICU 出院后 6 个月和 12 个月进行。为了能够解释 ICU 组中结局变量得分的趋势，将通过年龄和性别与 ICU 组相匹配，从瑞士人群中招募 150 名参与者作为对照组，在与 ICU 组相同的时间间隔进行访谈。