Division of Pulmonary, Allergy and Critical Care, Emory University School of Medicine, Atlanta, GA, USA.
Crit Care Med. 2011 Dec;39(12):2728-35. doi: 10.1097/CCM.0b013e318236f27e.
To review the current knowledge of common comorbidities in the intensive care unit, including diabetes mellitus, chronic obstructive pulmonary disease, cancer, end-stage renal disease, end-stage liver disease, HIV infection, and obesity, with specific attention to epidemiology, contribution to diseases and outcomes, and the impact on treatments in these patients.
Review of the relevant medical literature for specific common comorbidities in the critically ill.
Critically ill patients are admitted to the intensive care unit for various reasons, and often the admission diagnosis is accompanied by a chronic comorbidity. Chronic comorbid conditions commonly seen in critically ill patients may influence the decision to provide intensive care unit care, decisions regarding types and intensity of intensive care unit treatment options, and outcomes. The presence of comorbid conditions may predispose patients to specific complications or forms of organ dysfunction. The impact of specific comorbidities varies among critically ill medical, surgical, and other populations, and outcomes associated with certain comorbidities have changed over time. Specifically, outcomes for patients with cancer and HIV have improved, likely related to advances in therapy. Overall, the negative impact of chronic comorbidity on survival in critical illness may be primarily influenced by the degree of organ dysfunction or the cumulative severity of multiple comorbidities.
Chronic comorbid conditions are common in critically ill patients. Both the acute illness and the chronic conditions influence prognosis and optimal care delivery for these patients, particularly for adverse outcomes and complications influenced by comorbidities. Further work is needed to fully determine the individual and combined impact of chronic comorbidities on intensive care unit outcomes.
综述重症监护病房常见合并症（包括糖尿病、慢性阻塞性肺疾病、癌症、终末期肾病、终末期肝病、HIV 感染和肥胖症）的现有知识，重点关注流行病学、对疾病和结局的影响，以及对这些患者治疗的影响。
对重症患者特定常见合并症的相关医学文献进行综述。
重症患者因各种原因入住重症监护病房，入院诊断常伴有慢性合并症。重症患者常见的慢性合并症可能会影响提供重症监护治疗的决策、重症监护治疗方案的类型和强度的决策以及结局。合并症的存在可能使患者易患特定的并发症或器官功能障碍形式。特定合并症的影响在重症医学、外科和其他人群中有所不同，并且与某些合并症相关的结局随时间而变化。具体而言，癌症和 HIV 患者的结局有所改善，这可能与治疗的进步有关。总体而言，慢性合并症对重症患者生存的负面影响可能主要受器官功能障碍程度或多种合并症的累积严重程度影响。
慢性合并症在重症患者中很常见。急性疾病和慢性疾病都会影响这些患者的预后和最佳治疗效果，尤其是受合并症影响的不良结局和并发症。需要进一步研究以充分确定慢性合并症对重症监护结局的个体和综合影响。
