欢迎来到《四川大学学报(医学版)》
曹兴, 廖雪莲, 贺小丽等. 老年脓毒症患者远期病死率及生活质量的预测因素分析[J]. 四川大学学报(医学版), 2018, 49(1): 140-144.
引用本文: 曹兴, 廖雪莲, 贺小丽等. 老年脓毒症患者远期病死率及生活质量的预测因素分析[J]. 四川大学学报(医学版), 2018, 49(1): 140-144.
CAO Xing, LIAO Xue-lian, HE Xiao-li. et al. Predictors of Long-term Mortality and Health Related Quality of Life for Elderly Patients with Sepsis[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(1): 140-144.
Citation: CAO Xing, LIAO Xue-lian, HE Xiao-li. et al. Predictors of Long-term Mortality and Health Related Quality of Life for Elderly Patients with Sepsis[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(1): 140-144.

老年脓毒症患者远期病死率及生活质量的预测因素分析

Predictors of Long-term Mortality and Health Related Quality of Life for Elderly Patients with Sepsis

  • 摘要: 目的 探讨老年脓毒症患者远期病死率及生活质量的影响因素。方法 纳入重症监护病房(ICU)内年龄≥60岁的脓毒症患者238例,转出ICU 1年后进行电话随访,统计院内病死率及1年累计病死率;采用单因素及多因素分析影响患者1年病死率的危险因素,采用欧洲五维健康量表(EQ5D)进行生活质量的评估,单因素及多因素分析影响远期生活质量的因素。 结果 238例老年脓毒症患者住院期间共有58例(24.4%)患者死亡,1年累计病死率为59.7%(142例)。单因素分析显示急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)、脓毒症、真菌感染、入ICU 24 h内拔管以及使用血管活性药物、连续性肾脏替代治疗(CRRT)、机械通气时间与患者1年病死结局相关,多因素Cox回归分析提示, APACHEⅡ评分升高、使用CRRT、存在真菌感染是预测患者1年病死结局的独立危险因素;生活质量评估的单因素分析显示:患者APACHE Ⅱ评分、腹腔感染、住院时间、 24 h内气管导管是否拔除是影响远期生活质量的因素,而多因素logistic回归分析显示:入ICU 24 h拔管对1年后的生活质量起保护作用,住院时间越长1年后的生活质量越差。 结论 老年脓毒症患者1年病死率高。ICU内早期拔除气管内导管及住院时间是其远期生活质量的预测因素。

     

    Abstract: Objective To explore the predictors of long-term mortality and healthy related quality of life (HR-QoL) for elderly patients with sepsis. Methods Two hundred and thirty-eight septic patients older than 60 years old admitted to intensive care unit (ICU) were enrolled in the study, and were followed up by telephone interview one year after ICU discharge. The hospital mortality and cumulative one-year mortality were analyzed, single and multiple factors analysis were used to for the risk factors of 1-year mortality. Quality of life (QoL) was evaluated by the Euro QoL-5 Dimensions (EQ5D) questionnaire, and the influential factors of long-term QoL were also analyzed. Results A total of 238 patients were enrolled, 58 patients of them(24.4%) died during hospitalization and one-year accumulative mortality was 59.7% (142 cases). Single factor analysis showed that acute physiology and chronic health evaluation (APACHE Ⅱ), continuous renal replacement therapy (CRRT), fungal infection, sepsis, tracheal extubation and use of vasopressor within 24 h, the length of mechanical ventilation were correlated with one-year mortality. Multivariate regression analysis showed that APACHE Ⅱscore, CRRT and fungal infection were independent risk factors for one-year mortality, while tracheal extubation within 24 h and shorter length of ICU stay were related to better quality of life. Conclusion One-year mortality of elderly patients with sepsis was high. Tracheal extubation in 24 h and length of hospital stay were predictor of long-term QoL.

     

/

返回文章
返回