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根据体重指数(BMI)和白蛋白值对入住重症监护病房的老年患者的病程和预后进行比较。

Comparison of the Course and Prognosis of Geriatric Patients Admitted to the Intensive Care Unit According to BMI and Albumin Values.

作者信息

Onal Ozkan, Ozgun Gulten

机构信息

Department of Anesthesia and Intensive Care, Medical Faculty, Selcuk University, Konya, Turkey.

Department of Anesthesia and Intensive Care, Ataturk Education and Training Hospital, Ankara, Turkey.

出版信息

Anesth Pain Med. 2016 Jan 17;6(1):e32509. doi: 10.5812/aapm.32509. eCollection 2016 Feb.

Abstract

BACKGROUND

Elderly patients constitute the majority of patients undergoing treatment in the intensive care unit (ICU). Patients over the age of 65 account for 42%-52% of admission to ICU. Previous studies have shown that malnutrition is an important factor influencing the prognosis in intensive care.

OBJECTIVES

In this study, the effect of body mass index (BMI) and albumin values at first admission to the ICU on the course and prognosis of geriatric patients were investigated.

PATIENTS AND METHODS

Patients over the age of 65 who were admitted to the anesthesia ICU were included in the study. Demographic and clinical data were recorded retrospectively. Major outcome variables were length of ICU and hospital stay, mortality rate, BMI, and albumin values. APACHE II and SOFA scores at admission were evaluated.

RESULTS

Overall, 113 patients were included in the study. Mean BMI (kg/m(2)) value was found to be lower in the died group than in the discharged and transferred groups (P < 0.001). Albumin levels were lower in the died group than in the discharged and transferred groups (P < 0.001). An inverse relation was found between Apache and BMI and albumin values, whereas a significant direct relation was found between Apache and mechanical ventilation day (P < 0.05). A significant negative correlation was found between SOFA and BMI and albumin, values, respectively, and a positive correlation was found between SOFA and mechanical ventilation duration (P < 0.005).

CONCLUSIONS

In this study, a low albumin level (≤ 3 mg/dL) was an indicator of nutritional status. Patients' albumin levels, BMI, nutritional status, APACHE II score, and SOFA score were associated with mortality. Age in itself did not predict mortality in the elderly.

摘要

背景

老年患者是重症监护病房(ICU)接受治疗患者的主体。65岁以上患者占ICU收治患者的42%-52%。既往研究表明,营养不良是影响重症监护预后的重要因素。

目的

本研究探讨首次入住ICU时的体重指数(BMI)和白蛋白值对老年患者病程及预后的影响。

患者与方法

纳入65岁以上入住麻醉ICU的患者。回顾性记录人口统计学和临床数据。主要结局变量为ICU住院时间、住院时间、死亡率、BMI和白蛋白值。评估入院时的急性生理与慢性健康状况评分系统(APACHE II)和序贯器官衰竭评估(SOFA)评分。

结果

总体而言,113例患者纳入本研究。死亡组的平均BMI(kg/m²)值低于出院组和转院组(P<0.001)。死亡组的白蛋白水平低于出院组和转院组(P<0.001)。发现APACHE评分与BMI和白蛋白值呈负相关,而APACHE评分与机械通气天数呈显著正相关(P<0.05)。分别发现SOFA评分与BMI和白蛋白值呈显著负相关,SOFA评分与机械通气时长呈正相关(P<0.005)。

结论

本研究中,低白蛋白水平(≤3mg/dL)是营养状况的一个指标。患者的白蛋白水平、BMI、营养状况、APACHE II评分和SOFA评分与死亡率相关。年龄本身并不能预测老年人的死亡率。

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