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脓毒性休克后长期死亡率和生活质量:一项随访观察研究。

Long-term mortality and quality of life after septic shock: a follow-up observational study.

机构信息

Département d'Anesthésie-Réanimation 1, Inserm U991, Service de Réanimation Chirurgicale, Hôpital Pontchaillou, Université Rennes 1, Rennes, France.

出版信息

Intensive Care Med. 2013 May;39(5):881-8. doi: 10.1007/s00134-013-2815-1. Epub 2013 Jan 29.

Abstract

PURPOSE

In septic shock, short-term outcomes are frequently reported, while long-term outcomes are not. The aim of this study was to evaluate mortality and health-related quality of life (HRQOL) in survivors 6 months after an episode of septic shock.

METHODS

This single-centre observational study was conducted in an intensive care unit in a university hospital. All patients with septic shock were included. Mortality was assessed 6 months after the onset of septic shock, and a comparison between patients who survived and those who died was performed. HRQOL was assessed using the MOS SF-36 questionnaire prior to hospital admission (baseline) and at 6 months in survivors. HRQOL at baseline and at 6 months were compared to the general French population, and HRQOL at baseline was compared to 6-month HRQOL.

RESULTS

Ninety-six patients were included. Six-month mortality was 45%. Survivors were significantly younger, had significantly lower lactate levels and SAPS II scores, required less renal support, received less frequent administration of corticosteroids, and had a longer length of hospital stay. At baseline (n = 39) and 6 months (n = 46), all of the components of the SF-36 questionnaire were significantly lower than those in the general population. Compared to baseline (n = 23), the Physical Component Score (CS) improved significantly at 6 months, the Mental CS did not differ.

CONCLUSIONS

Mortality 6 months after septic shock was high. HRQOL at baseline was impaired when compared to that of the general population. Although improvements were noted at 6 months, HRQOL remained lower than that in the general population.

摘要

目的

在脓毒性休克中,常报告短期预后,而长期预后则不然。本研究旨在评估脓毒性休克发作后 6 个月存活患者的死亡率和健康相关生活质量(HRQOL)。

方法

这是一项在大学附属医院的重症监护病房进行的单中心观察性研究。所有脓毒性休克患者均纳入研究。在脓毒性休克发作后 6 个月评估死亡率,并对存活患者和死亡患者进行比较。在入院前(基线)和存活患者的 6 个月时使用 MOS SF-36 问卷评估 HRQOL。将基线和 6 个月时的 HRQOL 与一般法国人群进行比较,并将基线时的 HRQOL 与 6 个月时的 HRQOL 进行比较。

结果

共纳入 96 例患者。6 个月死亡率为 45%。存活患者明显更年轻,乳酸和 SAPS II 评分明显较低,需要的肾脏支持较少,皮质类固醇的使用频率较低,住院时间较长。在基线(n=39)和 6 个月(n=46)时,SF-36 问卷的所有组成部分均明显低于一般人群。与基线时(n=23)相比,6 个月时的生理成分评分(CS)显著改善,心理 CS 无差异。

结论

脓毒性休克发作后 6 个月的死亡率较高。与一般人群相比,基线时的 HRQOL 受损。尽管在 6 个月时有所改善,但 HRQOL 仍低于一般人群。

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