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| 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 |
| 顯示於類別: | [醫務管理系(所)] 期刊論文
[通識教育中心] 期刊論文
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