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重症监护病房出院后六个月的健康相关生活质量和预测因素。

Health related quality of life and predictive factors six months after intensive care unit discharge.

机构信息

Department of Anaesthesia and Critical Care, Magellan Medico-Surgical Centre, CHU Bordeaux, 33000 Bordeaux, France; Inserm, UMR 1034, Biology of Cardiovascular Diseases, University of Bordeaux, 33600 Pessac, France.

Department of Anaesthesia and Critical Care, Magellan Medico-Surgical Centre, CHU Bordeaux, 33000 Bordeaux, France.

出版信息

Anaesth Crit Care Pain Med. 2019 Apr;38(2):137-141. doi: 10.1016/j.accpm.2018.05.007. Epub 2018 Jun 1.

Abstract

BACKGROUND

Advances in critical care medicine have improved patients' survival rate. However, physical and cognitive sequels after Intensive Care Unit (ICU) discharge remain substantial. Our objectives were to evaluate the Health-related Quality of Life (HRQL) at 6-month after ICU discharge and identify the risk factors of this outcomes.

METHODS

We performed a single-centre prospective observational study. The components of Short Form 36 (SF-36) were analysed for assessing HRQL on preadmission and at 3- and 6-month after ICU discharge.

RESULTS

During the study period, 438 patients were eligible for recruitment and 220 of them were included in the trial. During the follow-up period, bodily pain and role limitations relating to emotion were both improved in comparison to the preadmission status while physical role component was lower at 3- and 6- month after ICU discharge. There was no other significant change in the SF-36 domains. Mental as well as physical aggregates remained also unchanged. Most of preadmission SF-36 scores were lower in patients who died within the first 6 months of follow-up compared to those who are still alive. Factors independently associated with the 6-month HRQL were age, preadmission HRQL score, SAPS II, prolonged mechanical ventilation (>3 days) and the occurrence of acute respiratory distress syndrome.

CONCLUSION

In our Cohort, ICU stay does not seem to alter globally neither the mental nor the physical component of the HRQL at 6-month after the discharge. However, some domains of the SF-36 are subject to significant changes.

摘要

背景

重症监护医学的进步提高了患者的生存率。然而,重症监护病房(ICU)出院后的身体和认知后遗症仍然很多。我们的目的是评估 ICU 出院后 6 个月的健康相关生活质量(HRQL),并确定这些结果的危险因素。

方法

我们进行了一项单中心前瞻性观察研究。在入院前、ICU 出院后 3 个月和 6 个月时,分析了短表 36(SF-36)的组成部分,以评估 HRQL。

结果

在研究期间,有 438 名患者符合入选条件,其中 220 名患者纳入试验。在随访期间,与入院前相比,身体疼痛和与情绪有关的角色限制都有所改善,而在 ICU 出院后 3 个月和 6 个月时,身体角色部分较低。SF-36 各领域均无其他显著变化。心理和身体综合评分也保持不变。与存活至 6 个月的患者相比,在随访的前 6 个月内死亡的患者的入院前 SF-36 评分大多较低。与 6 个月 HRQL 独立相关的因素是年龄、入院前 HRQL 评分、SAPS II、机械通气时间延长(>3 天)和急性呼吸窘迫综合征的发生。

结论

在我们的队列中,ICU 入住似乎不会在出院后 6 个月时整体改变 HRQL 的心理或身体成分。然而,SF-36 的某些领域会发生显著变化。

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