Polmear C M, Nathan H, Bates S, French C, Odisho J, Skinner E, Karahalios A, McGain F
Research Fellow, Biostatistics Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria.
Anaesth Intensive Care. 2017 Nov;45(6):720-726. doi: 10.1177/0310057X1704500612.
We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients' attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post-ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post-ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post-ICU discharge (odds ratio 2.98; 95% confidence interval 1.07 to 8.26; =0.036). Six months post-ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.
我们试图估算入住大都市重症监护病房（ICU）的患者中当前吸烟者的比例，以及ICU幸存者中吸烟者与ICU出院后六个月戒烟和/或减少吸烟量之间的关系。我们在维多利亚州墨尔本的一家大都市三级ICU进行了一项前瞻性队列研究。符合纳入标准的连续100名患者被纳入研究。纳入标准包括在ICU入院时为吸烟者、ICU住院时间超过一天、存活至ICU出院并提供书面知情同意书的患者。参与者在ICU出院后和出院前完成了一份专门设计的问卷，其中包括尼古丁依赖的Fagerstrom测试以及对患者戒烟态度的评估。在ICU出院六个月后，通过电话对参与者进行再次访谈。在1062名入住ICU的患者中，253名（23%）为当前吸烟者，100名被纳入研究。在ICU出院六个月后，86名存活且可联系的参与者中有28名（33%）戒烟，35名（41%）减少了吸烟量。报告的每日吸烟中位数减少了40%。最初认为其入住ICU与吸烟有关的参与者在ICU出院六个月后更有可能戒烟（优势比2.98；95%置信区间1.07至8.26；P=0.036）。在ICU出院六个月后，86名参与者中有63名（74%）戒烟或减少了吸烟量。表明需要对ICU幸存者进行有针对性的戒烟咨询的进一步研究。
