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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

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  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=62, 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=107, 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=89, 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=92, 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=92, 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=62, 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=107, 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=89, 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=92, 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=92, 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=62, 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=107, 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=89, 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=92, 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=92, 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=62, 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=107, 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=89, 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=92, 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=92, 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=62, 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=107, 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=89, 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=92, 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=92, 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

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