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入住重症监护病房的蛛网膜下腔出血患者的一年期转归及生活质量:一项单中心回顾性试点研究

One-year outcome and quality of life of patients with subarachnoid hemorrhage admitted to intensive care unit: a single-center retrospective pilot study.

作者信息

Bergamini Carlo, Brogi Etrusca, Salvigni Sara, Romoli Michele, Bini Giovanni, Venditto Alessandra, Lafe Elvis, D'Andrea Marcello, Tosatto Luigino, Ruggiero Maria, Agnoletti Vanni, Russo Emanuele

机构信息

Department of Emergency Surgery and Trauma, Anesthesia and Intensive Care Unit, Bufalini Hospital, Azienda Unità Sanitaria Locale (AUSL) Della Romagna, Cesena, Italy.

Neuroscience Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

出版信息

J Anesth Analg Crit Care. 2025 Jan 3;5(1):2. doi: 10.1186/s44158-024-00223-w.

Abstract

Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included. Disability and quality of life were evaluated via telephone interview after 12-15 months after initial bleeding using GOSE and EuroQoL, respectively. Baseline and clinical course characteristics were analyzed to evaluate relation with poor outcome defined as GOSE ≤ 3. Final population consisted of 38 patients. Twenty-four patients (63.2%) had favorable outcome (GOSE ≥ 4). Among 29 patients (76.3%) who survived at 1 year, median EQ-5D Index was 0.743 (IQR 0.287), while median EQ-VAS was 74.79 (IQR 18.5). Median EQ-5D Index and median EQ-VAS were higher among patients with favorable outcome (EQ-5D Index p = 0.037, EQ-VAS p = 0.003). Among baseline characteristics, only HH scale showed a significant relation with disability at one year (p = 0.033). Between complications occurred during ICU-stay only early HICP was related with unfavorable outcome (p = 0.028). Higher HH scale and early HICP were related with unfavorable outcome. Among patients with unfavorable outcome, quality of life has a broad range of variability, and this result should be taken into account when reporting patient-centered outcomes.

摘要

非创伤性蛛网膜下腔出血(SAH)后入住重症监护病房(ICU)的患者具有独特的特征,关于该人群长期预后的数据很少。我们在一家意大利重症监护病房进行了一项单中心回顾性研究。纳入所有入住ICU的非创伤性SAH患者(ICD-9-CM诊断代码430)。分别在初次出血后12 - 15个月通过电话访谈,使用格拉斯哥预后扩展量表(GOSE)和欧洲五维健康量表(EuroQoL)评估残疾情况和生活质量。分析基线和临床病程特征,以评估与定义为GOSE≤3的不良预后的关系。最终研究人群包括38例患者。24例患者(63.2%)预后良好(GOSE≥4)。在1年存活的29例患者(76.3%)中,EQ-5D指数中位数为0.743(四分位间距0.287),而EQ视觉模拟量表(EQ-VAS)中位数为74.79(四分位间距18.5)。预后良好的患者中EQ-5D指数中位数和EQ-VAS中位数更高(EQ-5D指数p = 0.037,EQ-VAS p = 0.003)。在基线特征中,只有Hunt-Hess量表在1年时与残疾有显著关系(p = 0.033)。在ICU住院期间发生的并发症中,只有早期颅内压增高(HICP)与不良预后相关(p = 0.028)。较高的Hunt-Hess量表评分和早期颅内压增高与不良预后相关。在预后不良的患者中,生活质量有很大的变异性,在报告以患者为中心的结果时应考虑到这一结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cb8/11697876/175c226b7fea/44158_2024_223_Fig1_HTML.jpg

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