Schuster H P
Medizinische Klinik I, Sttdtisches Krankenhaus Hildesheim, Lehrkrankenhaus der Medizinischen Hochschule Hannover.
Med Klin (Munich). 1998 Feb 15;93(2):91-8. doi: 10.1007/BF03043283.
The mean hospital mortality of patients after intensive therapy in Germany is about 15%, the mortality within the intensive care unit about 8%. Short-term prognosis is mainly determined by severity of disease, type of disease and patient age.
The impact of disease severity is measured by acute physiology score systems. The significance of disease categories becomes apparent in disease states with a continuing high mortality. Age is an independent risk factor. The higher risk of older patients cannot be explained by different diagnosis, and it is not secondary to a less aggressive therapy. The same factors mainly determine long-term prognosis. The 5-year-survival rate after intensive therapy is around 60%, a 3-fold increase as compared to the general population. Dependent upon the disease category, survival curves of intensive care patients parallel survival curves of the general population 2 years after admission. Analysis of quality of life is based upon objective measurement and subjective estimation of health-related life quality in the physical, psychological, and social life domain. Patients after intensive therapy experience a moderate but significant decrease in quality of life. This is the case in global estimations of quality of life as well as in investigations of different life domains.
The remaining quality of life is tolerable. This is in accordance with the positive overall judgement of intensive care by patients themselves. The chief problem of intensive care remain diseases with continuing high mortality.
在德国，接受强化治疗的患者的平均医院死亡率约为15%，重症监护病房内的死亡率约为8%。短期预后主要由疾病严重程度、疾病类型和患者年龄决定。
疾病严重程度的影响通过急性生理学评分系统来衡量。疾病类别在死亡率持续居高不下的疾病状态中变得明显。年龄是一个独立的风险因素。老年患者较高的风险无法用不同的诊断来解释，也不是由于治疗不够积极所致。相同的因素主要决定长期预后。强化治疗后的5年生存率约为60%，与普通人群相比增加了3倍。根据疾病类别，重症监护患者的生存曲线在入院2年后与普通人群的生存曲线平行。生活质量分析基于对身体、心理和社会生活领域与健康相关的生活质量的客观测量和主观估计。接受强化治疗后的患者生活质量有适度但显著的下降。在生活质量的总体估计以及不同生活领域的调查中都是如此。
剩余的生活质量是可以忍受的。这与患者自身对重症监护的总体积极评价一致。重症监护的主要问题仍然是死亡率持续居高不下的疾病。
