年龄对重症监护病房死亡率的影响：马来西亚的一项回顾性队列研究。
The impact of age on mortality in the intensive care unit: a retrospective cohort study in Malaysia.
作者信息
Ismail Abdul Jabbar, Hassan W Mohd Nazaruddin W, Nor Mohd Basri Mat, Shukeri Wan Fadzlina Wan Muhd
机构信息
School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Sabah Anaesthesia, Critical Care and Pain Management (SACCPM) Research Group, University Malaysia Sabah, Kota Kinabalu, Malaysia.
出版信息
Acute Crit Care. 2024 Aug;39(3):390-399. doi: 10.4266/acc.2024.00640. Epub 2024 Aug 12.
BACKGROUND
Age is a significant consideration for intensive care unit (ICU) admission. However, the reported associations between increasing age and mortality vary across studies, and data in the local context of Malaysia are lacking. The objective of the present study was to determine the impact of increasing age on ICU mortality.
METHODS
A retrospective cohort study of ICU patients was conducted between January 2020 and November 2023 at a university hospital in Malaysia. Patients were classified into two categories according to age (years) and into four groups according to National Library of Medicine Medical Subject Headings (MeSH): young adult (19-24), adult (25-44), middle age (45-64), and elderly (≥65). The Cochran-Armitage test for trend and Cox proportional hazards regression analyses were performed to evaluate the impact of increasing age on ICU mortality.
RESULTS
A total of 1,661 patients was analyzed. The Cochran-Armitage test showed a significant positive association between ICU mortality rate and age group (Z=-4.86, P<0.01) or MeSH category (Z=-5.36, P<0.01). After adjusting for other confounders, the strongest predictor for ICU mortality in the Cox proportional hazards regression analyses was age, with the elderly age group having the highest adjusted hazard ratio of 4.777 (95% CI, 1.128-20.231; P=0.03).
CONCLUSIONS
Age had a significant impact on ICU mortality in our cohort of critically ill patients.
背景
年龄是重症监护病房（ICU）收治的一个重要考量因素。然而，不同研究报道的年龄增长与死亡率之间的关联存在差异，且马来西亚当地缺乏相关数据。本研究的目的是确定年龄增长对ICU死亡率的影响。
方法
2020年1月至2023年11月在马来西亚一家大学医院对ICU患者进行了一项回顾性队列研究。患者按年龄（岁）分为两类，按美国国立医学图书馆医学主题词表（MeSH）分为四组：青年成人（19 - 24岁）、成人（25 - 44岁）、中年（45 - 64岁）和老年（≥65岁）。进行 Cochr an - Armitage趋势检验和Cox比例风险回归分析，以评估年龄增长对ICU死亡率的影响。
结果
共分析了1661例患者。 Cochr an - Armitage检验显示ICU死亡率与年龄组（Z = - 4.86，P < 0.01）或MeSH类别（Z = - 5.36，P < 0.01）之间存在显著正相关。在调整其他混杂因素后，Cox比例风险回归分析中ICU死亡率的最强预测因素是年龄，老年年龄组的调整后风险比最高，为4.777（95%CI，1.128 - 20.231；P = 0.03）。
结论
年龄对我们这组重症患者的ICU死亡率有显著影响。
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