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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32493


    標題: Prognosis of patients with acute respiratory failure and prolonged intensive care unit stay
    作者: Lai, Chih-Cheng
    Tseng, Kuei-Ling
    Chung-Han Ho(何宗翰)
    Shyh-Ren Chiang(蔣士仁)
    Chen, Chin-Ming
    Chan, Khee-Siang
    Chin-Ming Chen(陳欽明)
    Hsing, Shu-Chen
    Cheng, Kuo-Chen
    貢獻者: Chi Mei Med Ctr, Dept Intens Care Med
    Chi Mei Med Ctr, Dept Internal Med
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Engn
    關鍵字: Acute respiratory failure (ARE)
    prolonged intensive care unit stay (prolonged ICU stay)
    mortality
    prognostic factor
    日期: 2019-05
    上傳時間: 2020-07-29 13:47:15 (UTC+8)
    出版者: AME PUBL CO
    摘要: Background: Reasons for the prolonged critical care support include uncertainty of outcome, the complex dynamic created between physicians with care team members and the patient's family over a general unwillingness to surrender to unfavorable outcomes. The purpose of this study was to investigate outcomes and identify risk factors of patients with acute respiratory failure (ARF) who required a prolonged intensive care unit (ICU) stay (>= 21 days). It may provide reference to screen patients who are suitable for hospice care. Methods: The medical records of all ARF patients with a prolonged ICU stay were retrospectively reviewed. The primary outcome was in-hospital mortality. Results: We identified 1,189 patients. Sepsis (n=896, 75.4%) was the most common cause of prolonged ICU stays, following by renal failure (n=232, 19.5%), and unstable hemodynamic status vasopressors or arrhythmia (n=208, 17.5%). Using multivariable logistic regression, we identified eight risk factors of death: age >75 years, ICU stay for more than 28 days, APACHE II score >= 25, unstable hemodynamic status, renal failure, hepatic failure, massive gastrointestinal tract bleeding, and using a fraction of inspired oxygen (FiO(2)) 40%. The overall in-hospital mortality rate was 53.6% (n=637), and it up to 75.3% (216/287) for patients with at least three risk factors. Conclusions: The outcome of patients with ARF who required prolonged ICU stay was poor. They had a high risk of in-hospital mortality. Palliative care should be considered as a reasonable option for the patients at high risk of death.
    關聯: Journal of Thoracic Disease, v.11, n.5, pp. 2051-2057
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