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196 例 ICU 住院后间质性肺病患者的两年随访。

Two-year follow-up of 196 interstitial lung disease patients after ICU stay.

机构信息

Service de Réanimation Médico-Chirurgicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, Institut national de la santé et de la recherche médicale (INSERM) Hypoxie & Poumon, Bobigny.

Service de Réanimation Médico-Chirurgicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny.

出版信息

Int J Tuberc Lung Dis. 2021 Mar 1;25(3):199-205. doi: 10.5588/ijtld.20.0706.

Abstract

Interstitial lung diseases (ILDs) are associated with poor prognosis in the intensive care unit (ICU). We aimed to assess factors associated with hospital mortality in ILD patients admitted to the ICU and to investigate long-term outcome. This was a retrospective study in a teaching hospital specialised in ILD management. Patients with ILD who were hospitalised in the ICU between 2000 and 2014 were included. Independent predictors of hospital mortality were identified using logistic regression. A total of 196 ILD patients were admitted to the ICU during the study period. Overall hospital mortality was 55%. Two years after ICU admission, 70 (36%) patients were still alive. Of the 196 patients, 108 (55%) required invasive mechanical ventilation, of whom 21 (20%) were discharged alive from hospital. Acute exacerbation of ILD and multi-organ failure were highly associated with hospital mortality (OR 5.4, 95% CI 1.9-15.5 and OR 12.6, 95% CI 4.9-32.5, respectively). Hospital mortality among ILD patients hospitalised in the ICU was high, but even where invasive mechanical ventilation was required, a substantial number of patients were discharged alive from hospital. Multi-organ failure could lead to major ethical concerns.

摘要

间质性肺疾病(ILDs)与重症监护病房(ICU)的预后不良有关。我们旨在评估 ICU 收治的ILD 患者的住院死亡率相关因素,并探讨其长期预后。这是一项在一家专门从事ILD 管理的教学医院进行的回顾性研究。研究纳入了 2000 年至 2014 年期间在 ICU 住院的ILD 患者。使用逻辑回归确定住院死亡率的独立预测因素。在研究期间,196 名ILD 患者被收入 ICU。总体住院死亡率为 55%。ICU 入住 2 年后,70 名(36%)患者仍然存活。在 196 名患者中,108 名(55%)需要有创机械通气,其中 21 名(20%)从医院出院时存活。ILD 急性加重和多器官衰竭与住院死亡率高度相关(OR5.4,95%CI1.9-15.5 和 OR12.6,95%CI4.9-32.5)。ILD 患者在 ICU 住院的死亡率很高,但即使需要有创机械通气,仍有大量患者从医院出院时存活。多器官衰竭可能引发重大伦理问题。

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