Baidu
map

Crit Care:ICU治疗的难治性癫痫持续状态患者住院和1年死亡率预测

2017-03-27 xing.T MedSci原创

尽管较低的住院死亡率、25%的ICU治疗RSE患者在1年内死亡。在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。

近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员旨在通过一个人群为基础的研究确定在ICU治疗的难治性癫痫持续状态(RSE)患者住院和1年死亡率的预测因素。

这是一项在3年期间(2010-2012年)来自于芬兰重症监护协会(FICC)数据库中的芬兰ICU治疗的RSE成年(16岁以上)患者中进行的回顾性研究。该数据库包括20家芬兰医院,在ICU接诊治疗RSE。所有五所大学医院和15个中央医院中的11家医院参加了本研究。在研究医院的成年转诊人口总数为392万人,占芬兰成年人口的91%。其中具有缺氧病因基础的患者被排除在外。

研究人员确定了395例在ICU治疗的RSE患者,对应的年发病率为3.4/100000(95%可信区间(CI)为3.04-3.71)。医院死亡率为7.4%(95%CI为0-16.9%),1年死亡率为25.4%(95%CI为21.2-29.8%)。出院时的死亡率与器官功能障碍的严重程度相关。在1年时的死亡率与年龄较大(调整后的比值比(aOR)为1.033,95%CI为1.104-1.051,P=0.001)、序贯器官衰竭评分(SOFA)评分(aOR为1.156,95%CI为1.051-1.271,P=0.003)、超难治性癫痫持续状态(SRSE)(AOR为2.215,95%CI为1.20-3.84,P=0.010)和日常生活活动能力(ADL)的依赖性(aOR为2.553,95%CI为1.537-4.243,P<0.0001)有关。

尽管较低的住院死亡率、25%的ICU治疗RSE患者在1年内死亡。在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。

原始出处:

Anne-Mari Kantanen, et al. Predictors of hospital and one-year mortality in intensive care patients with refractory status epilepticus: a population-based study.Critical Care.2017. http://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1661-x

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1528338, encodeId=c7e9152833882, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed Mar 29 10:41:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183209, encodeId=db7f1832093f, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Tue Mar 28 07:53:55 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183110, encodeId=78d91831105f, content=学习了。又有新的收获了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAU2wVkTeANBK9R3rSMa9LcU72r7swR61YTJ7oZWL1MzhnJhRqMIsPZvCgHPwqmpYhDYKYK7dcwibS/0, createdBy=0cab1623974, createdName=hanchunhee, createdTime=Mon Mar 27 21:20:26 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183109, encodeId=ce0418310968, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=527f1683990, createdName=o9887, createdTime=Mon Mar 27 21:16:07 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183102, encodeId=a4c9183102e4, content=在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Mon Mar 27 20:55:30 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-29 freve
  2. [GetPortalCommentsPageByObjectIdResponse(id=1528338, encodeId=c7e9152833882, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed Mar 29 10:41:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183209, encodeId=db7f1832093f, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Tue Mar 28 07:53:55 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183110, encodeId=78d91831105f, content=学习了。又有新的收获了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAU2wVkTeANBK9R3rSMa9LcU72r7swR61YTJ7oZWL1MzhnJhRqMIsPZvCgHPwqmpYhDYKYK7dcwibS/0, createdBy=0cab1623974, createdName=hanchunhee, createdTime=Mon Mar 27 21:20:26 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183109, encodeId=ce0418310968, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=527f1683990, createdName=o9887, createdTime=Mon Mar 27 21:16:07 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183102, encodeId=a4c9183102e4, content=在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Mon Mar 27 20:55:30 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-28 tofsw

    谢谢分享学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1528338, encodeId=c7e9152833882, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed Mar 29 10:41:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183209, encodeId=db7f1832093f, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Tue Mar 28 07:53:55 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183110, encodeId=78d91831105f, content=学习了。又有新的收获了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAU2wVkTeANBK9R3rSMa9LcU72r7swR61YTJ7oZWL1MzhnJhRqMIsPZvCgHPwqmpYhDYKYK7dcwibS/0, createdBy=0cab1623974, createdName=hanchunhee, createdTime=Mon Mar 27 21:20:26 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183109, encodeId=ce0418310968, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=527f1683990, createdName=o9887, createdTime=Mon Mar 27 21:16:07 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183102, encodeId=a4c9183102e4, content=在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Mon Mar 27 20:55:30 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-27 hanchunhee

    学习了。又有新的收获了。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1528338, encodeId=c7e9152833882, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed Mar 29 10:41:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183209, encodeId=db7f1832093f, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Tue Mar 28 07:53:55 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183110, encodeId=78d91831105f, content=学习了。又有新的收获了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAU2wVkTeANBK9R3rSMa9LcU72r7swR61YTJ7oZWL1MzhnJhRqMIsPZvCgHPwqmpYhDYKYK7dcwibS/0, createdBy=0cab1623974, createdName=hanchunhee, createdTime=Mon Mar 27 21:20:26 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183109, encodeId=ce0418310968, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=527f1683990, createdName=o9887, createdTime=Mon Mar 27 21:16:07 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183102, encodeId=a4c9183102e4, content=在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Mon Mar 27 20:55:30 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-27 o9887

    学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1528338, encodeId=c7e9152833882, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Wed Mar 29 10:41:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183209, encodeId=db7f1832093f, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=74221626377, createdName=tofsw, createdTime=Tue Mar 28 07:53:55 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183110, encodeId=78d91831105f, content=学习了。又有新的收获了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAU2wVkTeANBK9R3rSMa9LcU72r7swR61YTJ7oZWL1MzhnJhRqMIsPZvCgHPwqmpYhDYKYK7dcwibS/0, createdBy=0cab1623974, createdName=hanchunhee, createdTime=Mon Mar 27 21:20:26 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183109, encodeId=ce0418310968, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=527f1683990, createdName=o9887, createdTime=Mon Mar 27 21:16:07 CST 2017, time=2017-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183102, encodeId=a4c9183102e4, content=在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170207/IMG589913E36908D4741.jpg, createdBy=99331680071, createdName=knowheart, createdTime=Mon Mar 27 20:55:30 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-27 knowheart

    在ICU入住时超难治性、ADL功能的依赖性、器官功能障碍的严重程度和较大的年龄可以预测长期死亡率。

    0

相关资讯

除了插管,麻醉医生在ICU还能做什么?

香港有两套并行的体系对 ICU 医生进行培训和认证,一是香港麻醉科医学院下设的危重病学科,另一个是香港内科医学院下设的深切治疗科。目前内科医学院培训出来的 ICU 医生已经占据主要地位。而香港中文大学则设立有麻醉与深切治疗系(A&IC),麻醉和重症医学的关系体现得更加紧密。然而,在目前中心 ICU 剧烈扩容,专科 ICU 设立极为火爆之时,麻醉似乎与重症医学的关系愈发疏远。在有些医院,IC

J Crit Care:ICU中药物间相互作用:它们真的影响大吗?

用药安全是药物治疗的前提。2017年4月,发表在《J Crit Care》的一项横断面研究调查了重症监护室(ICU)中的药物间相互作用情况。

Crit Care Med:蛛网膜下腔出血患者的ICU死亡率研究

本项多中心回顾性队列研究的主要目的是描述蛛网膜下腔出血患者入住ICU期间的住院死亡率。次要目的是确定与劣质结局相关的临床特征,比较蛛网膜下腔出血和其他神经系统疾病的死亡率,探讨蛛网膜下腔出血的标准化死亡率变化。 数据来自于澳大利亚和新西兰重症监护学会成人患者结局和资源评估数据库中心。所有可用的记录的期限为2000年1月至2015年6月。 研究纳入了11327例蛛网膜下腔出血患者。总病死

出事了,网红捅马蜂窝捅进了 ICU

这个世界上不乏没事干就作死的人,重庆一网络主播为了吸粉,花500元租了一台吊车来到有马蜂窝的树下“直播捅马蜂窝”。他戴上摩托车头盔,披上雨衣,站在吊车上来到30米高树头处。直播不一会儿,这位主播就陷入昏迷,被紧急送进附近医院。经检查,马蜂从裤脚进入,在他身上蜇了37处伤口,随后被转入重症监护室。所谓“无知者无畏”估计就是指这些人吧。其实在临床中经常会出现一些令我们大跌眼镜的患者。这些患者异于常人的

JAMA:视频喉镜与直接喉镜相比,对首次经口气管插管的ICU患者并无益处!

在重症监护病房(ICU)中,气管插管可能与并发症风险的增加有关。由于患者病情的突发不稳定性,通常需要由非专业技能的医师进行快速干预。视频喉镜检查可以通过改善声门可视化来降低这种风险。近期,一项发表在JAMA杂志上的文章研究了,在ICU患者中,与直接喉镜检查相比,视频喉镜检查是否增加首次气管插管成功的频率。研究选取2015年5月至2016年1月期间,在法国7个ICU接受治疗的371名需要插管的成年患

Crit Care Med:高龄患者入住ICU的长期预后分析

目的:描述高龄(≥80岁)患者入住ICU的分类和预后。 设计:多中心前瞻性观察研究。 地点:挪威三所非大学医院和三所大学医院。 患者:2013年11月至2014年10月重症监护病房住院的80岁或以上患者。 干预:无。 结果:在355名患者中,105 (29.6%)例被ICU拒绝予以重症监护治疗;“太虚弱/太老”的患者被ICU拒绝治疗的危险因素有高龄、身体机能很差;“太

Baidu
map
Baidu
map
Baidu
map