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印度北部一家呼吸重症监护病房出院幸存者的长期生存情况和生活质量:一项前瞻性研究。

Long-term Survival and Quality of Life among Survivors Discharged from a Respiratory ICU in North India: A Prospective Study.

作者信息

Kodati Rakesh, Muthu Valliappan, Agarwal Ritesh, Dhooria Sahajal, Aggarwal Ashutosh Nath, Prasad Kuruswamy Thurai, Behera Digambar, Sehgal Inderpaul Singh

机构信息

Department of Pulmonary Medicine, STAR Hospitals, Hyderabad, Telangana, India.

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.

出版信息

Indian J Crit Care Med. 2022 Oct;26(10):1078-1085. doi: 10.5005/jp-journals-10071-24321.

Abstract

BACKGROUND

Advancements in the intensive care unit (ICU) have improved critically ill subjects' short-term outcomes. However, there is a need to understand the long-term outcomes of these subjects. Herein, we study the long-term outcomes and factors associated with poor outcomes in critically ill subjects with medical illnesses.

MATERIALS AND METHODS

All subjects (≥12 years) discharged after an ICU stay of at least 48 hours were included. We evaluated the subjects at 3 and 6 months after ICU discharge. At each visit, subjects were administered the World Health Organization Quality of Life Instrument (WHO-QOL-BREF) questionnaire. The primary outcome was mortality at 6 months after ICU discharge. The key secondary outcome was quality of life (QOL) at 6 months.

RESULTS

In total, 265 subjects were admitted to the ICU, of whom 53 subjects (20%) died in the ICU, and 54 were excluded. Finally, 158 subjects were included: 10 (6.3%) subjects were lost to follow-up. The mortality at 6 months was 17.7% (28/158). Most subjects [16.5% (26/158)] died within the initial 3 months after ICU discharge. Quality of life scores were low in all the domains of WHO-QOL-BREF. About 12% ( = 14) of subjects could not perform the activity of daily living at 6 months. After adjusting for covariates, ICU-acquired weakness at the time of discharge (OR 15.12; 95% CI, 2.08-109.81, <0.01) and requirement for home ventilation (OR 22; 95% CI, 3.1-155, <0.01) were associated with mortality at 6 months.

CONCLUSION

Intensive care unit survivors have a high risk of death and a poor QOL during the initial 6 months following discharge.

HOW TO CITE THIS ARTICLE

Kodati R, Muthu V, Agarwal R, Dhooria S, Aggarwal AN, Prasad KT, . Long-term Survival and Quality of Life among Survivors Discharged from a Respiratory ICU in North India: A Prospective Study. Indian J Crit Care Med 2022;26(10):1078-1085.

摘要

背景

重症监护病房(ICU)的进步改善了危重症患者的短期预后。然而,有必要了解这些患者的长期预后情况。在此,我们研究患有内科疾病的危重症患者的长期预后以及与不良预后相关的因素。

材料与方法

纳入所有在ICU住院至少48小时后出院的患者(≥12岁)。我们在ICU出院后3个月和6个月对患者进行评估。每次随访时,向患者发放世界卫生组织生活质量量表(WHO-QOL-BREF)问卷。主要结局是ICU出院后6个月的死亡率。关键次要结局是6个月时的生活质量(QOL)。

结果

共有265名患者入住ICU,其中53名患者(20%)在ICU死亡,54名被排除。最终,纳入158名患者:10名(6.3%)患者失访。6个月时的死亡率为17.7%(28/158)。大多数患者[16.5%(26/158)]在ICU出院后的最初3个月内死亡。WHO-QOL-BREF所有领域的生活质量得分均较低。约12%( = 14)的患者在6个月时无法进行日常生活活动。在对协变量进行校正后,出院时的ICU获得性肌无力(比值比15.12;95%置信区间,2.08 - 109.81,<0.01)和家庭通气需求(比值比22;95%置信区间,3.1 - 155,<0.01)与6个月时的死亡率相关。

结论

ICU幸存者在出院后的最初6个月内死亡风险高且生活质量差。

如何引用本文

Kodati R, Muthu V, Agarwal R, Dhooria S, Aggarwal AN, Prasad KT, 。印度北部呼吸ICU出院幸存者的长期生存和生活质量:一项前瞻性研究。《印度重症监护医学杂志》2022;26(10):1078 - 1085。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a8/9983681/62f3e8d67110/ijccm-26-1078-g001.jpg

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