荷兰非 ICU 病房收治患者的不插管状态和 COVID-19 死亡率。
Do-not-intubate status and COVID-19 mortality in patients admitted to Dutch non-ICU wards.
机构信息
Department of Pulmonary Medicine, Erasmus MC, Rotterdam, the Netherlands.
Department of Pulmonary Medicine, Amphia Hospital, Breda, the Netherlands.
出版信息
Eur J Clin Microbiol Infect Dis. 2021 Oct;40(10):2207-2209. doi: 10.1007/s10096-021-04223-4. Epub 2021 Mar 12.
Abstract
Mortality from COVID-19 has been particularly high in elderly patients on mechanical ventilation. Treatment outcomes for patients with do-not-intubate (DNI) status are unknown. One hundred patients admitted to the non-ICU ward during the "first wave" were retrospectively analyzed. Mortality rate was 49% in patients with a DNI order. This subgroup was characterized by significantly higher age, more comorbidity, and care dependency. Mortality among DNI patients was three times higher than other patients, but not higher than some of the published mortality rates for elderly mechanically ventilated patients. Advanced care planning is essential in COVID-19 to assist patient autonomy and prevent non-beneficial medical interventions.
摘要
COVID-19 导致接受机械通气的老年患者死亡率特别高。对于有“不插管”（DNI）状态的患者，治疗结果未知。回顾性分析了“第一波”期间入住非 ICU 病房的 100 名患者。有 DNI 医嘱的患者死亡率为 49%。该亚组的特点是年龄明显更大、合并症更多、依赖护理。DNI 患者的死亡率是其他患者的三倍，但并不高于一些已发表的老年机械通气患者的死亡率。在 COVID-19 中，高级医疗护理计划至关重要，以帮助患者实现自主决策，并防止不必要的医疗干预。
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