Hortigüela-Martín Victoria A, Sanchez-Casado Marcelino, Rodríguez-Villar Sancho, Quintana-Díaz Manuel, Marco-Schulke Carlos, Gómez-Tello Vicente, Cabezas Martín Henar, Arrese-Cosculluela Maria Ángeles
Servicio de Medicina Intensiva, Complejo Hospitalario de Toledo, Toledo, España.
Med Clin (Barc). 2013 Jun 4;140(11):479-86. doi: 10.1016/j.medcli.2012.09.043. Epub 2013 Jan 18.
To assess the post-Intensive Care Unit (ICU) mortality (in-hospital and one year after hospital discharge) and the associated factors.
Cohort design in medical-surgical patients with multi-organ dysfunction syndrome (MODS) during the first 24h of admission to ICU. We recorded the following data: personal background, functional general situation, general information about admission to ICU, hospital stay and contact by phone after one year of hospital discharge. We registered mortality at the follow-up at anytime. Cox regression was performed to evaluate mortality factors.
Five hundred and forty five patients were recruited. During the study period 256 patients (52.9%) died; out of them 29.5% in ICU; 14.8% of 384 patients transferred to the ward died. Of 327 discharged patients, 266 (81.3%) were contacted; 14.3% of those had died. In-hospital death-related factors were age (odds ratio [OR] 1.04; 95% confidence interval [95% CI] 1.02-1.06; P<.01) and a decreased functional general status (OR 1.7; 95% CI 1.1-2.9; P<.05). Post-hospitalisation mortality-related variables were: diminished functional general status (OR 2.42; 95% CI 1.23-4.75; P<.01) and readmission after discharge from hospital (1.45 OR; 95% CI 1.19-1.76; P<.001).
Patients admitted for a medical-surgical MODS presented a mortality of 52.9% within one year. The factors influencing hospital mortality are age and a generally diminished functional status, both being not modifiable factors. After discharge, the decreased general functional status remained central along with the re-hospitalisation.
评估重症监护病房（ICU）后的死亡率（住院期间及出院后一年）及相关因素。
对入住ICU的最初24小时内发生多器官功能障碍综合征（MODS）的内科和外科患者进行队列研究。我们记录了以下数据：个人背景、功能总体状况、入住ICU的一般信息、住院时间以及出院一年后的电话随访情况。我们在随访期间随时记录死亡率。采用Cox回归评估死亡因素。
共纳入545例患者。在研究期间，256例患者（52.9%）死亡；其中29.5%在ICU死亡；转入病房的384例患者中有14.8%死亡。在327例出院患者中，266例（81.3%）接受了随访；其中14.3%已死亡。与住院死亡相关的因素为年龄（比值比[OR]1.04；95%置信区间[95%CI]1.02 - 1.06；P <.01）和功能总体状况下降（OR 1.7；95%CI 1.1 - 2.9；P <.05）。与出院后死亡相关的变量为：功能总体状况下降（OR 2.42；95%CI 1.23 - 4.75；P <.01）和出院后再次入院（OR 1.45；95%CI 1.19 - 1.76；P <.001）。
因内科或外科MODS入院的患者在一年内死亡率为52.9%。影响住院死亡率的因素为年龄和功能总体状况普遍下降，这两个因素均不可改变。出院后，功能总体状况下降以及再次入院仍是主要问题。
