Bài báo của chúng tôi 20 năm sau: Tỷ lệ sống sót sau 1 năm và chất lượng cuộc sống sau 6 tháng sau chăm sóc tích cực

Intensive Care Medicine - Tập 41 - Trang 605-614 - 2015
Maurizia Capuzzo1,2, Margherita Bianconi3
1c/o Section of Anaesthesia and Intensive Care, Department of Morphology, Surgery and Experimental Medicine, S. Anna Hospital, University of Ferrara, Ferrara, Italy
2Ethics Committee of the Province of Ferrara, c/o Azienda Ospedaliero-Universitaria S. Anna, Ferrara, Italy
3Service of Anaesthesia and Intensive Care, Department of Emergency, Azienda Ospedaliero-Universitaria S. Anna, Ferrara, Italy

Tóm tắt

Vào đầu những năm 1990, tỷ lệ tử vong nội viện của bệnh nhân trong đơn vị hồi sức cấp cứu (ICU) đã giảm, và sự quan tâm đến chất lượng cuộc sống (QOL) của những người sống sót sau ICU ngày càng tăng. Năm 1996, chúng tôi đã công bố một nghiên cứu để điều tra tỷ lệ sống sót sau 1 năm sau khi xuất viện và QOL sau 6 tháng chăm sóc tích cực. Hiện tại, chúng tôi so sánh các kết quả trước đó của mình với những kết quả được báo cáo trong tài liệu gần đây để đánh giá bất kỳ sự thay đổi nào và kiến thức mới trong lĩnh vực này. Tỷ lệ sống sót một năm của bệnh nhân ICU sau khi xuất viện là đáng kể, thấp hơn so với dân số chung và khác nhau giữa các nhóm con. Một số nghiên cứu cho thấy sự giảm sút về QOL sau 6 tháng, giống như trong nghiên cứu của chúng tôi, trong khi những nghiên cứu khác cho thấy sự cải thiện. Sự khác biệt về kết quả dường như chủ yếu liên quan đến sự kết hợp của bệnh nhân. Các nghiên cứu về các loại bệnh nhân khác nhau phát hiện ra rằng bệnh nhân sống sót sau ICU có suy giảm nhận thức lâu dài, có thể không đặc hiệu cho bệnh. Tỷ lệ bệnh nhân có các rối loạn tâm lý như rối loạn căng thẳng sau chấn thương, lo âu và trầm cảm mà chúng tôi mô tả sau nghiên cứu của chúng tôi không cho thấy bất kỳ sự thay đổi nào theo thời gian. Sự khác biệt giữa các nghiên cứu về sống sót lâu dài và QOL không cho phép rút ra kết luận về sự thay đổi theo thời gian. Không có sự thay đổi nào được tìm thấy trong các rối loạn tâm lý. Tuy nhiên, việc không có sự thay đổi có thể không được coi là tiêu cực, bởi vì bệnh nhân nặng sống sót sau ICU ngày nay có thể có nguy cơ cao hơn về kết quả lâu dài kém hơn so với trước đây do mức độ nghiêm trọng hơn của bệnh và các phương pháp điều trị tích cực hơn mà họ nhận được. Các nghiên cứu trong tương lai có thể cung cấp hiểu biết về mối quan hệ giữa các triệu chứng tâm thần, suy giảm nhận thức, khuyết tật chức năng và QOL.

Từ khóa

#tử vong nội viện #bệnh nhân ICU #chất lượng cuộc sống #suy giảm nhận thức #rối loạn tâm lý #sống sót lâu dài

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