老年呼吸重症监护病房患者预后的决定因素；感染或营养不良。
Determinants of prognosis in geriatric patients followed in respiratory ICU; either infection or malnutrition.
机构信息
University of Health Sciences, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey.
出版信息
Medicine (Baltimore). 2021 Sep 10;100(36):e27159. doi: 10.1097/MD.0000000000027159.
Severity of illness, age, malnutrition, and infection are the important factors determining intensive care unit (ICU) survival.The aim of the study is to determine the relations between Geriatric Nutritional Risk Index (GNRI), C-reactive protein/albumin (CAR), and prognosis-mortality of geriatric patients (age of ≥65 years) admitted to intensive care unit.The study with 10/15/2020, 697 approval date, and number retrospectively registered. Between January 1, 2018 and December 31, 2019, 413 geriatric patients admitted to ICU. The patients were divided into three groups according to their age.The age group, gender, Charlson comorbidity index, intensive care scores (Acute Physiology And Chronic Health Evaluation II and Sequential Organ Failure Assessment), the infection markers (white blood cell, procalcitonin, CAR levels), malnutrition tools for each patient (body mass index, Nutrition Risk in Critically ill score, and GNRI scores) were analyzed retrospectively. Also length of stay (LOS) ICU, length of stay hospital, and 30-day mortality were recorded.Geriatric patients number of 403 was included in the study. Forty-nine (12.3%) patients had a history of malignancy, 272 (67.5%) patients had Chronic Obstructive Pulmonary Disease comorbidity. There was no difference in mortality between age groups.In patients with mortality, body mass index, had being Chronic Obstructive Pulmonary Disease history, GNRI, length of stay hospital, and albumin were significantly lower; malignancy comorbidity rate, inotrope use, modified Nutrition Risk in Critically ill score, mechanical ventilation duration, LOS ICU, Sequential Organ Failure Assessment, Acute Physiology And Chronic Health Evaluation II, Charlson comorbidity index, C-reactive protein, procalcitonin, and CAR were significantly higher.Both malnutrition and infection affect mortality in geriatric patients in intensive care. The GNRI is better than CAR at predicting mortality.
疾病严重程度、年龄、营养不良和感染是决定重症监护病房（ICU）生存率的重要因素。本研究旨在确定老年营养风险指数（GNRI）、C 反应蛋白/白蛋白（CAR）与 ICU 收治的老年患者（年龄≥65 岁）预后-死亡率之间的关系。这项研究于 2020 年 10 月 15 日注册，批准日期为 2020 年 6 月 9 日，为回顾性研究。2018 年 1 月 1 日至 2019 年 12 月 31 日期间，共有 413 名老年患者入住 ICU。根据患者年龄将其分为三组。分析每组患者的年龄、性别、Charlson 合并症指数、重症监护评分（急性生理学和慢性健康评估 II 评分和序贯器官衰竭评估）、感染标志物（白细胞、降钙素原、CAR 水平）、每位患者的营养状况（体重指数、重症患者营养风险评分和 GNRI 评分）。还记录了 ICU 住院时间（LOS）、住院时间和 30 天死亡率。本研究共纳入 403 例老年患者。49 例（12.3%）患者有恶性肿瘤病史，272 例（67.5%）患者有慢性阻塞性肺疾病合并症。各组间死亡率无差异。死亡患者的体重指数、有慢性阻塞性肺疾病病史、GNRI、住院时间、白蛋白明显较低；恶性肿瘤合并症率、儿茶酚胺类药物使用、改良重症患者营养风险评分、机械通气时间、ICU 住院时间、序贯器官衰竭评估、急性生理学和慢性健康评估 II 评分、Charlson 合并症指数、C 反应蛋白、降钙素原和 CAR 明显较高。营养不良和感染均影响 ICU 老年患者的死亡率。GNRI 比 CAR 更能预测死亡率。
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