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危重症患者体重变化与临床结局的关系。

Association between weight change and clinical outcomes in critically ill patients.

机构信息

Public Health Center, Hapcheon-gun, Gyeonsang Namdo, Korea.

出版信息

J Crit Care. 2013 Dec;28(6):923-7. doi: 10.1016/j.jcrc.2013.07.055. Epub 2013 Sep 24.

Abstract

PURPOSE

Body weight fluctuates daily throughout a patient's stay in the intensive care unit (ICU) due to a variety of factors, including fluid balance, nutritional status, type of acute illness, and presence of comorbidities. This study investigated the association between change in body weight and clinical outcomes in critically ill patients during short-term hospitalization in the ICU.

METHODS

All patients admitted to the Gyeongsang National University hospital between January 2010 and December 2011 who met the inclusion criteria of age 18 or above and ICU hospitalization for at least 2 days were prospectively enrolled in this study. Body weight was measured at admission and daily thereafter using a bed scale. Univariate and multivariate linear and logistic regression analyses were performed to evaluate factors associated with mortality and the association between changes in body weight and clinical outcomes, including duration of mechanical ventilation (MV) use, length of ICU stay, and ICU mortality.

RESULTS

Of the 140 patients examined, 33 died during ICU hospitalization, yielding an ICU mortality rate of 23.6%. Non-survivors experienced higher rates of severe sepsis and septic shock and greater weight gain than survivors on days 2, 3, 4, 5, and 6 of ICU hospitalization (P < .05). Increase of body weight on days 2 through 7 on ICU admission was correlated with the longer stay of ICU, and increase on days 3 through 7 on ICU admission was correlated with the prolonged use of mechanical ventilation. Increase of body weight on days 3 through 5 on ICU admission was associated with ICU mortality.

CONCLUSIONS

Increase in body weight of critically ill patients may be correlated with duration of mechanical ventilation use and longer stay of ICU hospitalization and be associated with ICU mortality.

摘要

目的

由于各种因素,包括液体平衡、营养状况、急性疾病类型和合并症,患者在重症监护病房(ICU)的住院期间体重每天都会波动。本研究调查了 ICU 短期住院期间体重变化与危重症患者临床结局之间的关系。

方法

本研究前瞻性纳入了 2010 年 1 月至 2011 年 12 月期间入住韩国国立大学医院且符合年龄 18 岁及以上和 ICU 住院至少 2 天的纳入标准的所有患者。使用病床秤在入院时和此后的每天测量体重。进行单变量和多变量线性和逻辑回归分析,以评估与死亡率相关的因素以及体重变化与临床结局之间的关系,包括机械通气(MV)使用时间、ICU 住院时间和 ICU 死亡率。

结果

在检查的 140 名患者中,33 名在 ICU 住院期间死亡,ICU 死亡率为 23.6%。非幸存者在 ICU 住院第 2、3、4、5 和 6 天经历了更高的严重脓毒症和感染性休克发生率以及比幸存者更高的体重增加(P <.05)。入住 ICU 第 2 至 7 天体重增加与 ICU 住院时间延长有关,入住 ICU 第 3 至 7 天体重增加与机械通气时间延长有关。入住 ICU 第 3 至 5 天体重增加与 ICU 死亡率相关。

结论

危重症患者体重增加可能与机械通气使用时间和 ICU 住院时间延长有关,并与 ICU 死亡率相关。

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