Department of Internal Medicine, Division of Pulmonary and Critical Care, University of Michigan Ann Arbor, MI 48109, USA.
University of Michigan School of Medicine, Ann Arbor, MI, USA..
J Crit Care. 2018 Aug;46:55-57. doi: 10.1016/j.jcrc.2018.03.029. Epub 2018 Apr 4.
The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU.
We retrospectively studied a cohort of consecutive patients from a university hospital who were in an ICU for a minimum of 14 days during 2014-2016. We calculated daily Sequential Organ Failure Assessment (SOFA) scores from admission to ICU day 14. The primary outcome was the number of new late organ failures, defined as occurring on ICU day 4 through 14.
In a retrospective cohort of 3777 consecutive patients in six ICUs, 50 patients had prolonged ICU stays. Of those 50, new cardiovascular failure occurred in 24 (62%) on day 4 or later; persistent mechanical ventilation was present in only 28 (56%).
Strategies aiming to reduce the development of new late organ failures may be a novel target for preventing persistent critical illness.
本研究旨在描述长时间入住 ICU 患者（定义为至少在 ICU 中度过 14 天的患者）发生的器官衰竭情况。
我们回顾性研究了 2014 年至 2016 年期间，在一所大学医院 ICU 中至少住院 14 天的连续患者队列。我们计算了从入 ICU 到第 14 天的每日序贯器官衰竭评估（SOFA）评分。主要结局是新的晚期器官衰竭的数量，定义为在 ICU 第 4 天至第 14 天发生的器官衰竭。
在六个 ICU 的 3777 例连续患者的回顾性队列中，有 50 例患者 ICU 住院时间延长。在这 50 例患者中，有 24 例（62%）在第 4 天或以后出现新发心血管衰竭；仅 28 例（56%）存在持续机械通气。
旨在减少新的晚期器官衰竭发展的策略可能是预防持续危重病的新目标。
