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[长期撤机后患者与健康相关的生活质量取决于撤机状态]

[Long-term health-related quality of life of patients after prolonged weaning depending on weaning status].

作者信息

Schönhofer Bernd, Paul Andrea, Suchi Stefan, Zimmermann Maximilian, Stanzel Sarah Bettina, Windisch Wolfram, Berger Melanie

机构信息

Innere Medizin, Pneumologie und Intensivmedizin, EvKB, Universitätsklinikum Ostwestfalen Lippe (OWL) der Universität Bielefeld, Bielefeld, Deutschland.

Pneumologie, Internistische Intensivmedizin und Schlafmedizin, KRH Klinikum Siloah, Hannover, Deutschland.

出版信息

Pneumologie. 2025 Feb;79(2):141-146. doi: 10.1055/a-2368-4865. Epub 2024 Aug 5.

Abstract

INTRODUCTION

Long-term outcome in patients with prolonged weaning is known to be impaired, particularly against the background of their weaning status; however, data on their health-related quality of life (HRQL) are sparse.

METHODS

HRQL was measured in patients with prolonged weaning using the Severe Respiratory Insufficiency Questionnaire (SRI).

RESULTS

Overall, 39 out of 83 patients with prolonged weaning filled in the SRI questionnaire. The median interval between discharge from hospital and HRQL assessment was 3.5 years (IQR 2.4-4.5 years). In the total group, the median SRI summary score was 56.4 (IQR 38.8-73.5). Patients with unsuccessful weaning and subsequent invasive home mechanical ventilation (N=15) had worse HRQL as estimated from the SRI summary score when compared to those with successful weaning both without (n=13) and with subsequent long-term non-invasive ventilation (NIV) (n=11); Kruskal-Wallis-Test: H (2, n=39) = 7,875446; P=0.0195. Statistically significant differences indicating worse HRQL in patients with invasive home mechanical ventilation were particularly evident in the following SRI subscales: Social relationships (P=0.0325), Anxiety (P=0.0096), and Psychological well-being (P=0.0079).

CONCLUSIONS

HRQL is substantially impaired in patients with unsuccessful prolonged weaning and subsequent invasive home mechanical ventilation compared to those with successful prolonged weaning. Further studies incorporating higher case numbers are needed to assess other conditions potentially affecting HRQL in patients with prolonged weaning.

摘要

引言

已知长期撤机患者的长期预后较差,尤其是在其撤机状态的背景下;然而,关于他们与健康相关的生活质量(HRQL)的数据却很稀少。

方法

使用严重呼吸功能不全问卷(SRI)对长期撤机患者的HRQL进行测量。

结果

总体而言,83例长期撤机患者中有39例填写了SRI问卷。出院与HRQL评估之间的中位间隔时间为3.5年(四分位间距2.4 - 4.5年)。在整个组中,SRI总分的中位数为56.4(四分位间距38.8 - 73.5)。与撤机成功且未进行后续有创家庭机械通气的患者(n = 13)以及撤机成功且进行了后续长期无创通气(NIV)的患者(n = 11)相比,撤机失败并随后进行有创家庭机械通气的患者(N = 15)根据SRI总分评估的HRQL更差;Kruskal - Wallis检验:H(2, n = 39) = 7.875446;P = 0.0195。在以下SRI子量表中,有创家庭机械通气患者HRQL较差的统计学显著差异尤为明显:社会关系(P = 0.0325)、焦虑(P = 0.0096)和心理健康(P = 0.0079)。

结论

与长期撤机成功的患者相比,长期撤机失败并随后进行有创家庭机械通气的患者的HRQL严重受损。需要纳入更多病例数的进一步研究来评估可能影响长期撤机患者HRQL的其他情况。

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