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埃塞俄比亚一家教学医院重症监护病房收治的老年危重症患者的疾病模式及死亡率预测因素:一项回顾性队列研究

Pattern of disease and predictors of mortality among critically ill geriatric patients admitted to intensive care unit at a teaching hospital in Ethiopia: a retrospective cohort study.

作者信息

Zegeye Sitotaw Tesfa, Nega Meseret Hulualem, Debas Simachew Amogne, Derseh Mulat Mossie, Endeshaw Amanuel Sisay

机构信息

Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.

Department of Anesthesia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia

出版信息

BMJ Open. 2025 Jul 1;15(7):e099038. doi: 10.1136/bmjopen-2025-099038.

Abstract

OBJECTIVE

This study aimed to assess the pattern of disease and predictors of mortality among critically ill geriatric patients admitted to the intensive care unit at a teaching hospital.

DESIGN

A single-centre retrospective cohort study.

SETTING

Medical-surgical intensive care unit of Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia.

PARTICIPANTS

We enrolled 296 critically ill patients (age 60+) admitted to the intensive care unit who stayed for more than 2 hours. Those patients with missing or incomplete records were excluded.

PRIMARY OUTCOME MEASURE

The primary outcome of this study was the time to death within 30 days following intensive care unit admission.

RESULTS

In this cohort, the overall mortality rate of geriatric patients in the intensive care unit was found to be 42.9%. The incidence rate of mortality was 6.3 deaths per 100 person-days observation. Acute kidney injury (adjusted HR=2.36, 95% CI: 1.16, 3.68), coexisting diseases (adjusted HR=1.66, 95% CI: 1.13, 2.42), the presence of shock (adjusted HR=2.27, 95% CI: 1.66, 4.53) and mechanical ventilation (adjusted HR=1.82, 95% CI: 1.14, 2.89) were predictors of mortality in the intensive care unit.

CONCLUSIONS

The mortality rate in the intensive care unit among geriatric patients was high. Predictors of mortality in this population of critically ill geriatric patients included acute kidney injury, the presence of shock, coexisting diseases and mechanical ventilation in the intensive care unit.

摘要

目的

本研究旨在评估入住一家教学医院重症监护病房的老年危重症患者的疾病模式及死亡预测因素。

设计

单中心回顾性队列研究。

地点

埃塞俄比亚巴赫达尔市提贝贝·吉翁专科医院的内科-外科重症监护病房。

参与者

我们纳入了296名入住重症监护病房且停留超过2小时的60岁及以上老年危重症患者。排除记录缺失或不完整的患者。

主要结局指标

本研究的主要结局是重症监护病房入院后30天内的死亡时间。

结果

在该队列中,重症监护病房老年患者的总体死亡率为42.9%。死亡率为每100人日观察期6.3例死亡。急性肾损伤(校正风险比=2.36,95%置信区间:1.16,3.68)、并存疾病(校正风险比=1.66,95%置信区间:1.13,2.42)、休克(校正风险比=2.27,95%置信区间:1.66,4.53)及机械通气(校正风险比=1.82,95%置信区间:1.14,2.89)是重症监护病房死亡的预测因素。

结论

老年患者在重症监护病房的死亡率很高。该老年危重症患者群体的死亡预测因素包括急性肾损伤、休克、并存疾病及重症监护病房中的机械通气。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72c1/12215130/bc403f322f2a/bmjopen-15-7-g002.jpg

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