Sage W M, Rosenthal M H, Silverman J F
Crit Care Med. 1986 Sep;14(9):777-82. doi: 10.1097/00003246-198609000-00004.
The high cost of treatment in an ICU is clearly recognized; the ultimate benefit of that care in prolonging meaningful life is not as well quantified. We evaluated 337 mixed medical-surgical ICU patients for severity of illness and intensity of therapy and assessed their survival and quality of life 16 to 20 months after discharge. Mortality was 36.9% for emergency surgical and medical patients and 13.9% for elective surgical patients. A total of 140 patients responded to follow-up; 62.2% of patients not retired or homemakers were working full-time. Quality of life was good using both subjective and objective standards. There were few significant differences between elective surgical and other patients. Survival and life quality were related inversely to severity of illness and cost of treatment. Acute health on ICU admission predicted survival well; chronic health and age were better predictors of life quality.
重症监护病房（ICU）治疗费用高昂，这一点已得到明确认识；而这种治疗在延长有意义生命方面的最终益处却没有得到很好的量化。我们评估了337名内外科混合ICU患者的疾病严重程度和治疗强度，并在他们出院后16至20个月评估了他们的生存情况和生活质量。急诊手术和内科患者的死亡率为36.9%，择期手术患者的死亡率为13.9%。共有140名患者接受了随访；未退休或非家庭主妇的患者中有62.2%全职工作。使用主观和客观标准评估，生活质量良好。择期手术患者与其他患者之间几乎没有显著差异。生存和生活质量与疾病严重程度和治疗费用呈负相关。入住ICU时的急性健康状况对生存有很好的预测作用；慢性健康状况和年龄对生活质量的预测作用更好。
