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瑞典重症监护病房收治的65岁及以上患者的特征、结局与康复情况:一项纵向观察性多中心研究方案

Characteristics, Outcomes and Recovery of Patients 65 Years or Older Admitted to Swedish Intensive Care Units: A Protocol for a Longitudinal Observational Multicentre Study.

作者信息

Sundberg Fredrika, Kjellsdotter Anna, Lindberg Elisabeth, Backman Emma, Israelsson-Skogsberg Åsa

机构信息

Research, Education, Development and Innovation Department, Skaraborg Hospital Skövde, Skövde, Sweden.

The School of Health Sciences, Skövde University, Skövde, Sweden.

出版信息

Nurs Crit Care. 2025 Jul;30(4):e70109. doi: 10.1111/nicc.70109.

DOI:10.1111/nicc.70109
PMID:40642916
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12247021/
Abstract

BACKGROUND

There are little data on the impact of frailty on critically ill older patients treated in intensive care units (ICUs) and on their characteristics and outcomes. More understanding of the longitudinal health and recovery process is needed and of the recovery traits of older patients after intensive care.

AIM

This project aims to identify characteristics and outcomes in patients 65 years or older admitted to ICUs and to explore how health and recovery is experienced after discharge, with a special focus on frailty.

STUDY DESIGN

This research project will conduct both retrospective and prospective data collection with a sample of approximately 3200 patients. This is a longitudinal, multicentre, prospective, observational research project with a nested cohort covering 12 months of admissions and comprising four studies. The first aims to map the characteristics of patients admitted to the ICUs, their treatments and their outcomes. The second will use questionnaires to assess their health and recovery process up to 18 months after discharge. The third and fourth studies aim to describe and understand their lived experiences using research interviews, with the fourth study including only frail patients.

RELEVANCE TO CLINICAL PRACTICE

The project comprises studies that seek to identify the characteristics of older people admitted to ICUs, to examine how frailty impacts them and to understand what they experience during and foremost after intensive care. The project also aims to understand the facilitators and barriers to promoting health and recovery after discharge from ICUs and to contribute to the growing body of evidence supporting health and recovery initiatives. The results need to be spread and the knowledge sprung from this project may be implemented and used by intensive care unit clinicians.

摘要

背景

关于衰弱对重症监护病房(ICU)中接受治疗的老年重症患者的影响及其特征和预后的数据较少。需要更多地了解纵向健康和康复过程以及老年患者在重症监护后的康复特征。

目的

本项目旨在确定入住ICU的65岁及以上患者的特征和预后,并探讨出院后健康和康复情况,特别关注衰弱情况。

研究设计

本研究项目将对约3200名患者进行回顾性和前瞻性数据收集。这是一个纵向、多中心、前瞻性观察研究项目,有一个嵌套队列,涵盖12个月的入院病例,包括四项研究。第一项研究旨在梳理入住ICU患者的特征、治疗方法及其预后。第二项研究将使用问卷评估他们出院后长达18个月的健康和康复过程。第三项和第四项研究旨在通过研究访谈描述和了解他们的生活经历,第四项研究仅纳入衰弱患者。

与临床实践的相关性

该项目包括多项研究,旨在确定入住ICU的老年人的特征,研究衰弱如何影响他们,并了解他们在重症监护期间尤其是之后的经历。该项目还旨在了解促进ICU出院后健康和康复的促进因素和障碍,并为支持健康和康复倡议的越来越多的证据做出贡献。研究结果需要传播,该项目产生的知识可能会被ICU临床医生实施和应用。

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本文引用的文献

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A scoping review of older patients' health-related quality of life, recovery and well-being after intensive care.一项针对重症监护后老年患者健康相关生活质量、恢复和幸福感的范围综述。
Nurs Open. 2023 Sep;10(9):5900-5919. doi: 10.1002/nop2.1873. Epub 2023 Jun 12.
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Management and outcomes in critically ill nonagenarian versus octogenarian patients.老年九旬与八旬重症患者的管理及预后
BMC Geriatr. 2021 Oct 19;21(1):576. doi: 10.1186/s12877-021-02476-4.
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Katie Eriksson's caring theories. Part 1. The caritative caring theory, the multidimensional health theory and the theory of human suffering.凯蒂·埃里克森的关怀理论。第 1 部分。关怀性关怀理论、多维健康理论和人类苦难理论。
Scand J Caring Sci. 2022 Sep;36(3):782-790. doi: 10.1111/scs.13036. Epub 2021 Oct 5.
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Older patients' recovery following intensive care: A follow-up study with the RAIN questionnaire.老年重症监护患者的康复:使用 RAIN 问卷的随访研究。
Intensive Crit Care Nurs. 2021 Aug;65:103038. doi: 10.1016/j.iccn.2021.103038. Epub 2021 Mar 26.
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Long-term health-related quality of life and burden of disease after intensive care: development of a patient-reported outcome measure.长期重症监护后的健康相关生活质量和疾病负担:患者报告结局测量工具的开发。
Crit Care. 2021 Feb 25;25(1):82. doi: 10.1186/s13054-021-03496-7.
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Access to intensive care in 14 European countries: a spatial analysis of intensive care need and capacity in the light of COVID-19.14 个欧洲国家的重症监护病房资源获取情况:基于 COVID-19 分析重症监护需求和能力的空间分析。
Intensive Care Med. 2020 Nov;46(11):2026-2034. doi: 10.1007/s00134-020-06229-6. Epub 2020 Sep 4.
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Elderly Patients in the Intensive Care Unit.重症监护病房中的老年患者
Semin Respir Crit Care Med. 2021 Feb;42(1):10-19. doi: 10.1055/s-0040-1710571. Epub 2020 Aug 9.
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Associations between healthcare environment design and adverse events in intensive care unit.医疗环境设计与重症监护病房不良事件的关联。
Nurs Crit Care. 2021 Mar;26(2):86-93. doi: 10.1111/nicc.12513. Epub 2020 May 12.
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Global reach of ageism on older persons' health: A systematic review.全球老龄化对老年人健康的影响:系统综述。
PLoS One. 2020 Jan 15;15(1):e0220857. doi: 10.1371/journal.pone.0220857. eCollection 2020.
10
Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU.累积预后评分预测 ICU 收治的 80 岁以上患者的死亡率。
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