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新冠肺炎患者在重症监护病房接受治疗后 12 个月时的工作恢复和健康状况:一项前瞻性纵向研究。

Returning to work and health status at 12 months among patients with COVID-19 cared for in intensive care-A prospective, longitudinal study.

机构信息

Anesthesia and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Anesthesia and Intensive Care Medicine, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Integrative Physiology, Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden; Department of Epidemiology, McGill University, Montréal, Quebec, Canada; Lady Davis Institute of Medical Research, Jewish General Hospital, Montréal, Quebec, Canada.

出版信息

Intensive Crit Care Nurs. 2024 Dec;85:103806. doi: 10.1016/j.iccn.2024.103806. Epub 2024 Aug 24.

Abstract

OBJECTIVE

Intensive care unit (ICU) stay for a serious illness has a long-term impact on patients' physical and psychological well-being, affecting their ability to return to their everyday life. We aimed to investigate whether there are differences in health status between those who return to work and those who do not, and how demographic characteristics and illness severity impact patients' ability to return to work 12 months after intensive care for COVID-19.

RESEARCH METHODOLOGY

This was a prospective longitudinal cohort study. The participants were patients who had been in intensive care for COVID-19 and had worked before contracting COVID-19. Data on return to previous occupational status, demographic data, comorbidities, intensive care characteristics, and health status were collected at a 12-month follow-up visit.

SETTING

General ICU at the Uppsala University Hospital in Sweden.

RESULTS

Seventy-three participants were included in the study. Twelve months after discharge from the ICU, 77 % (n = 56) had returned to work. The participants who were unable to return to work reported more severe health symptoms. The (odds ratio [OR] for not returning to work was high for critical illness OR, 12.05; 95 % confidence interval [CI], 2.07-70.29, p = 0.006) and length of ICU stay (OR, 1.06; 95 % CI, 1.01-1.11, p = 0.01) CONCLUSION: Two-thirds of the participants were able to return to work within 1 year after discharge from the ICU. The primary factors contributing to the failure to work were duration of the acute disease and presence of severe and persistent long-term symptoms.

IMPLICATIONS FOR CLINICAL PRACTICE

Patients' health status must be comprehensively assessed and their ability to return to work should be addressed in the rehabilitation process. Therefore, any complications faced by the patients must be identified and treated early to increase the possibility of their successful return to work.

摘要

目的

患有重病在重症监护病房(ICU)的住院时间对患者的身心健康有长期影响,影响他们恢复日常生活的能力。我们旨在研究在 COVID-19 重症监护后 12 个月,那些返回工作岗位的人与那些没有返回工作岗位的人之间的健康状况是否存在差异,以及人口统计学特征和疾病严重程度如何影响患者返回工作岗位的能力。

研究方法

这是一项前瞻性纵向队列研究。参与者为因 COVID-19 而入住重症监护病房且在感染 COVID-19 前有工作的患者。在 12 个月的随访时收集有关返回先前职业状态、人口统计学数据、合并症、重症监护特征和健康状况的数据。

设置

瑞典乌普萨拉大学医院的普通 ICU。

结果

本研究共纳入 73 名参与者。在从 ICU 出院后 12 个月,77%(n=56)的人已返回工作岗位。无法返回工作岗位的参与者报告有更严重的健康症状。患有危重病(比值比[OR]为 12.05;95%置信区间[CI]为 2.07-70.29,p=0.006)和 ICU 住院时间较长(OR,1.06;95%CI,1.01-1.11,p=0.01)的参与者返回工作岗位的可能性较低。

结论

三分之二的参与者在从 ICU 出院后 1 年内能够返回工作岗位。导致无法工作的主要因素是急性疾病的持续时间以及严重和持续的长期症状。

临床意义

必须全面评估患者的健康状况,并在康复过程中解决他们返回工作的能力。因此,必须尽早识别和治疗患者面临的任何并发症,以增加他们成功返回工作的可能性。

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