需要重症监护的非手术病人的十年趋势：按入院年份划分的长期预后差异。

IF 2.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of cardiology Pub Date : 2024-06-18 DOI:10.1016/j.jjcc.2024.06.003

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引用次数: 0

摘要

研究背景本研究旨在阐明10年间需要重症监护的非手术患者的时间趋势对预后的影响：2012年至2021年期间，共有4276名需要重症监护的非手术患者入选。比较了五个组别[2012-2013年（n = 825）、2014-2015年（n = 784）、2016-2017年（n = 864）、2018-2019年（n = 939）和2020-2021年（n = 867）]患者的背景、院内管理和预后。在研究期间，平均年龄从2012-2013年的69岁显著增加到2020-2021年的72岁。急性生理学和慢性健康评估的平均得分从 2012-2013 年的 10 分显著增加到 2020-2021 年的 12 分。重症监护室的中位住院时间从 3 天增加到 4 天。卡普兰-米尔生存曲线分析表明，2020-2021年30天和365天的生存率明显低于2012-2013年，但在30天的Cox比例危险回归模型中，两者没有明显差异。Cox比例危险回归模型显示，2016-2017年入院的患者365天全因死亡风险明显更高（HR：1.324，95 % CI：1.042-1.680，p = 0.021），2018-2019年入院的患者365天全因死亡风险明显更高（HR：1.329，95 % CI：1.044-1.691，p = 0.021），2020-2021年入院的患者365天全因死亡风险明显更高（HR：1.409，95 % CI：1.115-1.779，p = 0.004）：结论：尽管治疗策略有所改善，但需要重症监护的患者的病情逐年加重，导致长期预后较差。这些发现强调了非手术重症监护病房入院后额外护理管理的重要性，尤其是对日本老龄化社会而言。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Ten-year trends in non-surgical patients requiring intensive care: Long-term prognostic differences by year of admission

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Ten-year trends in non-surgical patients requiring intensive care: Long-term prognostic differences by year of admission

Background

The aim of the present study is to elucidate prognostic impact of temporal trends of non-surgical patients requiring intensive care over a 10-year period.

Methods and Results

A total of 4276 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled. Patients' backgrounds, in-hospital management, and prognoses were compared between five groups [2012–2013 (n = 825), 2014–2015 (n = 784), 2016–2017 (n = 864), 2018–2019 (n = 939), and 2020–2021 (n = 867)]. During the study period, mean age significantly increased from 69 years in 2012–2013 to 72 years in 2020–2021. Mean Acute Physiology and Chronic Health Evaluation scores significantly increased from 10 points in 2012–2013 to 12 points in 2020–2021. The median duration of intensive care unit stays increased from 3 to 4 days. Kaplan-Meier survival curve analysis showed that survival rates during 30- and 365-days were significantly lower in 2020–2021 than in 2012–2013, but it was not significantly different by a Cox proportional hazards regression model in 30 days. A Cox proportional hazards regression model revealed that the risks of 365-day all-cause death were significantly higher in patients enrolled in 2016–2017 (HR: 1.324, 95 % CI: 1.042–1.680, p = 0.021), in 2018–2019 (HR: 1.329, 95 % CI: 1.044–1.691, p = 0.021), and in 2020–2021 (HR: 1.409, 95 % CI: 1.115–1.779, p = 0.004).

Conclusion

The condition of patients requiring intensive care is becoming more critical year by year, leading to poorer long-term prognoses despite improvements in treatment strategies. These findings emphasize the importance of additional care management after admission into non-surgical intensive care units, particularly for the aging society of Japan.

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来源期刊

Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.90

自引率

8.00%

发文量

202

审稿时长

29 days

期刊介绍： The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.