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首页> 外文期刊>Acute and critical care. >Trends in the Use of Intensive Care by Very Elderly Patients and Their Clinical Course in a Single Tertiary Hospital in Korea
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Trends in the Use of Intensive Care by Very Elderly Patients and Their Clinical Course in a Single Tertiary Hospital in Korea

机译：在韩国一家三级医院中，老年患者使用重症监护的趋势及其临床过程

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Background: The number of elderly patients admitted to intensive care units (ICUs) is growing with the increasing proportion of elderly persons in the Korean general population. It is often difficult to make decisions about ICU care for elderly patients, especially when they are in their 90s. Data regarding the proportion of elderly patients in their 90s along with their clinical characteristics in ICU are scarce. Methods: The records of Korean patients ≥ 90 years old who were admitted to the medical ICU in a tertiary referral hospital between January 2005 and December 2014 were retrospectively reviewed. We compared the trend in ICU use and characteristics of these elderly patients between 2005-2009 and 2010-2014. Results: Among 6,186 referred patients, 55 aged ≥ 90 years were admitted to the medical ICU from 2005 to 2014. About 58.2% of these patients were male, and their mean age was 92.7 years. Their median Charlson comorbidity index score was 2 (IQR 1-3) and their mean APACHE II score was 25.0 (IQR 19.0-34.0). The most common reason for ICU care was acute respiratory failure. There were no differences in the survival rates between the earlier and more recent cohorts. However, after excluding patients who had specified “do not resuscitate” (DNR), the more recent group showed a significantly higher survival rate (53.8% mortality for the earlier group and 0% mortality for the recent group). Among the survivors, over half were discharged to their homes. More patients in the recent cohort (n=26 [78.8%]) specified DNR than in the earlier cohort (n=7 [35.0%], p=0.004). The number and proportion of patients ≥ 90 years old among patients using ICU during the 2005-2014 study period did not differ. Conclusions: The use of ICU care by elderly patients ≥ 90 years old was consistent from 2005-2014. The overall mortality rate tended to decrease, but this was not statistically significant. However, the proportion of patients specifying DNR was higher among more recent patients, and the recent group showed an even better survivorship after sensitivity analysis excluded patients specifying DNR.
机译：背景：随着韩国普通人群中老年人比例的增加，重症监护病房（ICU）的老年患者人数也在增加。关于老年患者的ICU护理，通常很难做出决定，尤其是在他们90多岁的时候。关于90年代老年患者比例及其在ICU中的临床特征的数据很少。方法：回顾性分析2005年1月至2014年12月在三级转诊医院接受ICU诊治的90岁以上韩国患者的病历。我们比较了2005-2009年和2010-2014年间这些老年患者的ICU使用趋势和特征。结果：2005年至2014年，在6,186例转诊患者中，有55位年龄≥90岁的患者接受了医疗ICU。其中约58.2％是男性，平均年龄为92.7岁。他们的中位Charlson合并症指数得分为2（IQR 1-3），平均APACHE II得分为25.0（IQR 19.0-34.0）。重症监护病房护理的最常见原因是急性呼吸衰竭。在较早和较新的队列之间，生存率没有差异。但是，在排除指定“不进行复苏”（DNR）的患者之后，较新的组显示出明显更高的存活率（较早的组为53.8％的死亡率，而最近的组为0％的死亡率）。在幸存者中，有一半以上已出院。最近的队列（n = 26 [78.8％]）指定DNR的患者多于早期的队列（n = 7 [35.0％]，p = 0.004）。在2005年至2014年研究期间，使用ICU的患者中≥90岁的患者数量和比例没有差异。结论：从2005年至2014年，≥90岁的老年患者对ICU的使用保持一致。总体死亡率趋于下降，但这在统计学上并不显着。但是，在较新的患者中，指定DNR的患者比例更高，并且在敏感性分析中排除了指定DNR的患者后，最近的一组患者的生存率更高。

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