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严重 SARS-CoV2 感染患者 ICU 住院 1 年后生活质量恶化的预测因素。

Prognostic factors for deterioration of quality of life one year after admission to ICU for severe SARS-COV2 infection.

机构信息

Department of Anaesthesiology and Critical Care Medicine, Gregorio Maranon National Hospital, Madrid, Spain.

Department of General Surgery, Gregorio Maranon National Hospital, Madrid, Spain.

出版信息

Qual Life Res. 2024 Jan;33(1):123-132. doi: 10.1007/s11136-023-03503-0. Epub 2023 Aug 24.

Abstract

PURPOSE

Patients with COVID-19 present long-term symptoms collectively known as "post-COVID syndrome". Long-term manifestations are more frequent in patients requiring admission to Intensive Care Units (ICU), but the risk factors for their development are still unknown. This study explores the quality of life of patients with severe COVID-19 one year after their discharge from ICU.

METHODS

Prospective observational study including 106 patients admitted to the ICU of a tertiary care hospital between March and August 2020. We analysed quality of life using the EuroQol-5D index (EQ-5D). We evaluated as possible risk factors associated with a worse value of the EQ-5D index the medical record, the clinical situation at hospital admission, the clinical situation at ICU admission and evolution in the ICU. As a secondary objective, we explored the presence of other frequent symptoms.

RESULTS

Most patients (55.4%) reported that their quality of life worsened one year after admission. The mean perceived health status, on the EQ-VAS scale (0-100), was 70.4, with a median of 70 (RI 60-90). The median EQ-5D index was 0.91 (RI 0.76-1). The factors independently related to lower quality of life were female sex and duration of mechanical ventilation. Almost all (91%) of the patients had sequelae one year after discharge from the ICU. The most frequent manifestations were neuropsychiatric (71%).

CONCLUSIONS

Critically ill COVID-19 patients worsen their quality of life more than one year after discharge. Female sex and duration of mechanical ventilation predict a lower quality of life assessed by the EQ-5D index.

摘要

目的

患有 COVID-19 的患者会出现长期症状,统称为“新冠后综合征”。在需要入住重症监护病房(ICU)的患者中,长期表现更为常见,但发展的危险因素仍不清楚。本研究探讨了重症 COVID-19 患者从 ICU 出院一年后的生活质量。

方法

前瞻性观察研究,纳入了 2020 年 3 月至 8 月期间入住三级医院 ICU 的 106 名患者。我们使用欧洲五维健康量表(EQ-5D)分析生活质量。我们评估了与 EQ-5D 指数较差值相关的可能危险因素,包括病历、入院时的临床情况、入住 ICU 时的临床情况和 ICU 中的演变。作为次要目标,我们探讨了其他常见症状的存在。

结果

大多数患者(55.4%)报告说,他们的生活质量在入院一年后恶化。在 EQ-VAS 量表(0-100)上,平均感知健康状况为 70.4,中位数为 70(RI 60-90)。EQ-5D 指数中位数为 0.91(RI 0.76-1)。与生活质量较低独立相关的因素是女性和机械通气时间。几乎所有(91%)的患者在从 ICU 出院一年后仍有后遗症。最常见的表现是神经精神症状(71%)。

结论

患有重症 COVID-19 的患者在出院一年后生活质量恶化。女性和机械通气时间预测 EQ-5D 指数评估的生活质量较低。

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