Mariana Martins Siqueira Santos, Daniel Sganzerla, Isabel Jesus Pereira, Regis Goulart Rosa, Cristina Granja, Cassiano Teixeira, Luís Azevedo
{"title":"重症监护室幸存者接受持续性肾脏替代疗法与间歇性肾脏替代疗法后的长期死亡率和与健康相关的生活质量:重症监护室术后生活质量研究的二次分析》。","authors":"Mariana Martins Siqueira Santos, Daniel Sganzerla, Isabel Jesus Pereira, Regis Goulart Rosa, Cristina Granja, Cassiano Teixeira, Luís Azevedo","doi":"10.1177/08850666231224392","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> We assessed long-term outcomes in intensive care unit (ICU) survivors with acute kidney injury (AKI) submitted to intermittent or continuous renal replacement therapy (RRT) for comparisons between groups. <b>Methods:</b> The multicenter prospective cohort study included 195 adult ICU survivors with an ICU stay >72 h in 10 ICUs that had at least one episode of AKI treated with intermittent RRT (IRRT) or continuous RRT (CRRT) during ICU stay. The main outcomes were mortality and health-related quality of life (HRQoL). Hospital readmissions and physical dependence were also assessed. <b>Results:</b> Regarding RRT, 83 (42.6%) patients received IRRT and 112 (57.4%) received CRRT. Despite the similarity regarding sociodemographic characteristics, pre-ICU state of health and type of admission between groups, the risk of death (23.5% vs 42.7%; <i>P </i>< .001), the prevalence of sepsis (60.7%) and acute respiratory distress syndrome (17%) were higher at ICU admission among CRRT patients. The severity of critical illness was higher among CRRT patients, regarding the need for mechanical ventilation (75.0% vs 50.6%, <i>P</i> = .002) and vasopressors (91.1% vs 63.9%, <i>P</i> < .001). One year after ICU discharge, 67 of 195 ICU survivors died (34.4%) and, after adjustment for confounders, there were no significant differences in mortality when comparing IRRT and CRTT patients (34.9% vs 33.9%; <i>P = </i>.590), on HRQoL in both physical (41.9% vs 42.2%; <i>P </i>= .926) and mental dimensions (57.6% vs 56.6%; <i>P </i>= .340), and on the number of hospital readmissions and physical dependence. <b>Conclusions:</b> Our study suggests that among ICU survivors RRT modality (IRRT vs CRRT) in the ICU does not impact long-term outcomes after ICU discharge.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151712/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-Term Mortality and Health-Related Quality of Life After Continuous Versus Intermittent Renal Replacement Therapy in ICU Survivors: A Secondary Analysis of the Quality of Life After ICU Study.\",\"authors\":\"Mariana Martins Siqueira Santos, Daniel Sganzerla, Isabel Jesus Pereira, Regis Goulart Rosa, Cristina Granja, Cassiano Teixeira, Luís Azevedo\",\"doi\":\"10.1177/08850666231224392\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Purpose:</b> We assessed long-term outcomes in intensive care unit (ICU) survivors with acute kidney injury (AKI) submitted to intermittent or continuous renal replacement therapy (RRT) for comparisons between groups. <b>Methods:</b> The multicenter prospective cohort study included 195 adult ICU survivors with an ICU stay >72 h in 10 ICUs that had at least one episode of AKI treated with intermittent RRT (IRRT) or continuous RRT (CRRT) during ICU stay. The main outcomes were mortality and health-related quality of life (HRQoL). Hospital readmissions and physical dependence were also assessed. <b>Results:</b> Regarding RRT, 83 (42.6%) patients received IRRT and 112 (57.4%) received CRRT. Despite the similarity regarding sociodemographic characteristics, pre-ICU state of health and type of admission between groups, the risk of death (23.5% vs 42.7%; <i>P </i>< .001), the prevalence of sepsis (60.7%) and acute respiratory distress syndrome (17%) were higher at ICU admission among CRRT patients. The severity of critical illness was higher among CRRT patients, regarding the need for mechanical ventilation (75.0% vs 50.6%, <i>P</i> = .002) and vasopressors (91.1% vs 63.9%, <i>P</i> < .001). One year after ICU discharge, 67 of 195 ICU survivors died (34.4%) and, after adjustment for confounders, there were no significant differences in mortality when comparing IRRT and CRTT patients (34.9% vs 33.9%; <i>P = </i>.590), on HRQoL in both physical (41.9% vs 42.2%; <i>P </i>= .926) and mental dimensions (57.6% vs 56.6%; <i>P </i>= .340), and on the number of hospital readmissions and physical dependence. <b>Conclusions:</b> Our study suggests that among ICU survivors RRT modality (IRRT vs CRRT) in the ICU does not impact long-term outcomes after ICU discharge.</p>\",\"PeriodicalId\":16307,\"journal\":{\"name\":\"Journal of Intensive Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151712/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Intensive Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08850666231224392\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08850666231224392","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的:我们对接受间歇性或持续性肾脏替代治疗(RRT)的急性肾损伤(AKI)重症监护病房(ICU)幸存者的长期预后进行了评估,以进行组间比较。研究方法这项多中心前瞻性队列研究纳入了 10 个重症监护室中 195 名重症监护室住院时间超过 72 小时的成年重症监护室幸存者,他们在重症监护室住院期间至少发生过一次 AKI,并接受了间歇性 RRT(IRRT)或持续性 RRT(CRRT)治疗。主要结果是死亡率和健康相关生活质量(HRQoL)。此外,还对再住院率和身体依赖性进行了评估。结果显示关于 RRT,83 名患者(42.6%)接受了 IRRT,112 名患者(57.4%)接受了 CRRT。尽管两组患者的社会人口学特征、重症监护室前健康状况和入院类型相似,但死亡风险(23.5% vs 42.7%;P P = .002)和血管加压(91.1% vs 63.9%,P P = .590)、身体(41.9% vs 42.2%;P = .926)和精神(57.6% vs 56.6%;P = .340)方面的 HRQoL 以及再入院次数和身体依赖性方面的风险也相似。结论我们的研究表明,在重症监护室的幸存者中,重症监护室的 RRT 模式(IRRT 与 CRRT)不会影响重症监护室出院后的长期预后。
Long-Term Mortality and Health-Related Quality of Life After Continuous Versus Intermittent Renal Replacement Therapy in ICU Survivors: A Secondary Analysis of the Quality of Life After ICU Study.
Purpose: We assessed long-term outcomes in intensive care unit (ICU) survivors with acute kidney injury (AKI) submitted to intermittent or continuous renal replacement therapy (RRT) for comparisons between groups. Methods: The multicenter prospective cohort study included 195 adult ICU survivors with an ICU stay >72 h in 10 ICUs that had at least one episode of AKI treated with intermittent RRT (IRRT) or continuous RRT (CRRT) during ICU stay. The main outcomes were mortality and health-related quality of life (HRQoL). Hospital readmissions and physical dependence were also assessed. Results: Regarding RRT, 83 (42.6%) patients received IRRT and 112 (57.4%) received CRRT. Despite the similarity regarding sociodemographic characteristics, pre-ICU state of health and type of admission between groups, the risk of death (23.5% vs 42.7%; P < .001), the prevalence of sepsis (60.7%) and acute respiratory distress syndrome (17%) were higher at ICU admission among CRRT patients. The severity of critical illness was higher among CRRT patients, regarding the need for mechanical ventilation (75.0% vs 50.6%, P = .002) and vasopressors (91.1% vs 63.9%, P < .001). One year after ICU discharge, 67 of 195 ICU survivors died (34.4%) and, after adjustment for confounders, there were no significant differences in mortality when comparing IRRT and CRTT patients (34.9% vs 33.9%; P = .590), on HRQoL in both physical (41.9% vs 42.2%; P = .926) and mental dimensions (57.6% vs 56.6%; P = .340), and on the number of hospital readmissions and physical dependence. Conclusions: Our study suggests that among ICU survivors RRT modality (IRRT vs CRRT) in the ICU does not impact long-term outcomes after ICU discharge.
期刊介绍:
Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.