Hausmann D, Schulte am Esch J
Anasth Intensivther Notfallmed. 1982 Jun;17(3):139-44.
The prognosis of 1693 patients of the intensive care unit of the Neurochirurgische Universitätsklinik Bonn was investigated. They all required intubation and mechanical ventilation, 912 of them for more than 24 hours (prolonged intubation). The overall mortality rate was 25.3%, while in cases with prolonged intubation it was 41%. No valid conclusion could be drawn from the duration of intubation as to survival. Next to the primary disease which was most important, the patient's age was of great prognostic value. Pneumonia (16% incidence) and prerenal failure (14.9%) seemed to be of minor importance, whereas renal failure (16.6%) worsened prognosis considerably by a mortality of 71-100%. Dexamethasone therapy proved to be of advantage in the management of brain tumors. No influence on the outcome of patients with severe head injury was seen. Patients with cerebrovascular disease were detrimentally affected by corticosteroid administration. Apart from extreme situations there were no satisfying predictors of outcome by means of which one could preselect patients to enter intensive care units. The decision to eventually withdraw life support can only be made on the basis of numerous factors.
对波恩大学神经外科重症监护病房的1693例患者的预后进行了调查。他们均需要插管和机械通气，其中912例需要超过24小时（长时间插管）。总体死亡率为25.3%，而长时间插管患者的死亡率为41%。插管时间与生存情况之间无法得出有效的结论。除了最重要的原发性疾病外，患者年龄具有很大的预后价值。肺炎（发病率16%）和肾前性衰竭（14.9%）似乎不太重要，而肾衰竭（16.6%）使预后显著恶化，死亡率为71%-100%。地塞米松治疗在脑肿瘤的治疗中被证明是有益的。未观察到对重型颅脑损伤患者的预后有影响。脑血管疾病患者接受皮质类固醇治疗会受到不利影响。除极端情况外，没有令人满意的预后预测指标可用于预先选择进入重症监护病房的患者。最终停止生命支持的决定只能基于众多因素做出。
