三级护理中心医学重症监护病房中老年患者（>65岁）的临床和人口统计学特征
A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center.
作者信息
Prabhudev Pruthvi, Ramamoorthi Kusugodlu, Acharya Raviraja V
机构信息
Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
出版信息
Indian J Crit Care Med. 2023 Mar;27(3):166-175. doi: 10.5005/jp-journals-10071-24416.
BACKGROUND
The elderly population in India is expected to increase to 319 million by 2050. Managing critically ill elderly patients in intensive care units (ICUs) is a difficult task. Proper planning and development of healthcare infrastructure are of prime importance to face this challenge.
OBJECTIVES
To study the clinical profile and outcomes of elderly patients admitted to the medical ICUs.
MATERIALS AND METHODS
A time-bound, prospective observational study on elderly patients admitted to medical ICUs for more than 48 hours was conducted from March 2019 to September 2020. The demographic, biochemical, hematologic, and microbiological data on antibiotic susceptibility patterns on various organisms and procalcitonin (PCT) reports were collected. Acute Physiology and Chronic Health Evaluation II (APACHE II) score was calculated. Various treatment modalities, such as mechanical ventilation, inotropes, hemodialysis, antibiotics, culture report in sepsis patients, and length of ICU stay were collected.
RESULTS
The age of the patients and the length of their ICU stay were not significantly associated with outcomes. Sepsis and APACHE II scores are significantly associated with outcomes. Receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality ( < 0.001).
CONCLUSION
The patients' ages were not significantly associated with outcomes. The most common cause of death among elderly patients was found to be sepsis, followed by pneumonia. In elderly ICU patients, gram-negative organisms are the most common causative agents in bloodstream infections. The APACHE II score, sepsis, receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality.
HOW TO CITE THIS ARTICLE
Prabhudev P, Ramamoorthi K, Acharya RV. A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center. Indian J Crit Care Med 2023;27(3):166-175.
背景
预计到2050年，印度老年人口将增至3.19亿。在重症监护病房（ICU）管理重症老年患者是一项艰巨的任务。合理规划和发展医疗基础设施对于应对这一挑战至关重要。
目的
研究入住内科ICU的老年患者的临床特征和结局。
材料与方法
于2019年3月至2020年9月对入住内科ICU超过48小时的老年患者进行了一项有时间限制的前瞻性观察研究。收集了人口统计学、生化、血液学数据，以及各种生物体的抗生素敏感性模式和降钙素原（PCT）报告的微生物学数据。计算急性生理与慢性健康状况评分系统II（APACHE II）评分。收集了各种治疗方式，如机械通气、血管活性药物、血液透析、抗生素、脓毒症患者的培养报告以及ICU住院时间。
结果
患者年龄和ICU住院时间与结局无显著相关性。脓毒症和APACHE II评分与结局显著相关。接受机械通气、血管活性药物支持和血液透析与死亡率显著相关（P<0.001）。
结论
患者年龄与结局无显著相关性。老年患者最常见的死亡原因是脓毒症，其次是肺炎。在内科ICU患者中，革兰阴性菌是血流感染最常见的病原体。APACHE II评分、脓毒症、接受机械通气、血管活性药物支持和血液透析与死亡率显著相关。
如何引用本文
Prabhudev P, Ramamoorthi K, Acharya RV. 三级医疗中心内科重症监护病房老年（>65岁）患者的临床和人口统计学特征。《印度重症监护医学杂志》2023；27(3):166 - 175。
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