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首页> 外文期刊>Geriatrics & gerontology international. >Synergistic impact of low serum albumin on intensive care unit admission and high blood urea nitrogen during intensive care unit stay on post-intensive care unit mortality in critically ill elderly patients requiring mechanical ventilation
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Synergistic impact of low serum albumin on intensive care unit admission and high blood urea nitrogen during intensive care unit stay on post-intensive care unit mortality in critically ill elderly patients requiring mechanical ventilation

机译：低血清白蛋白对重症监护病房需要机械通气的老年患者的重症监护病房死亡率的影响

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Aims: To identify intensive care unit (ICU) risk factors for post-ICU 6-month (PI6M) mortality in critically ill elderly patients requiring mechanical ventilation (MV). Methods: The present study was a retrospective observational study carried out in a respiratory ICU from December 2008 to December 2009. Medical records of patients aged ??70years and receiving MV were reviewed. Risk factors of PI6M mortality were assessed by multivariate Cox regression. Results: Of 120 patients enrolled, 46 (38%) died in the PI6M period. As compared with survivors, non-survivors had lower serum albumin levels on ICU admission, lower estimated glomerular filtration rate, higher peak blood urea nitrogen (BUN) levels during ICU stay (ICU-peak BUN), a higher ratio of prolonged steroid use and longer MV length in ICU. Independent risk factors of PI6M mortality were low albumin on admission (hazard ratio [HR] 3.53 per g/dL decrease, 95% CI [1.97-6.33], P<0.001) and high ICU-peak BUN (HR 1.11 per 10-mg/dL increase, [1.04-1.18], P=0.001). The HR for PI6M mortality was 7.88 [2.97-20.91] for patients with both risk factors (albumin ??2.8g/dL and ICU-peak BUN >72mg/dL) as compared with those without. For patients with high ICU-peak BUN (>72mg/dL), PI6M survival was better for those with a reduction in BUN level to ??72mg/dL at ICU discharge than those without. Conclusions: Low serum albumin level on ICU admission and high BUN level during ICU stay are two independent risk factors, especially their combination, of PI6M mortality in critically ill elderly patients requiring MV. Furthermore, patients with a reduction in high BUN have a better PI6M survival. ? 2012 Japan Geriatrics Society.
机译：目的：确定重症监护病房需要机械通气（MV）的老年患者，ICU后6个月（PI6M）死亡率的重症监护病房（ICU）危险因素。方法：本研究为回顾性观察性研究，于2008年12月至2009年12月在呼吸性ICU中进行。对70岁并接受MV的患者的病历进行了回顾。 PI6M死亡的危险因素通过多元Cox回归进行评估。结果：120名患者中，有46名（38％）在PI6M期间死亡。与幸存者相比，非幸存者在ICU入院时血清白蛋白水平较低，估计的肾小球滤过率较低，在ICU住院期间（ICU-peak BUN）的峰值血尿素氮（BUN）较高，长期使用类固醇和更高的比例。 ICU中的MV长度更长。 PI6M死亡的独立危险因素是入院时白蛋白低（危险比[HR] 3.53每g / dL降低，95％CI [1.97-6.33]，P <0.001）和ICU峰值BUN高（HR 1.11每10毫克） / dL增加，[1.04-1.18]，P = 0.001）。两种危险因素（白蛋白≥2.8g/ dL，ICU-peak BUN> 72mg / dL）的患者的PI6M死亡率的HR为7.88 [2.97-20.91]。对于ICU峰值BUN高（> 72mg / dL）的患者，ICU出院时BUN水平降低至≤72mg/ dL的患者的PI6M存活率优于无ICU峰值的患者。结论：ICU入院时血清白蛋白水平低和ICU住院期间BUN水平高是两个重要的危险因素，尤其是二者的结合，是需要MV的重症老年患者PI6M死亡率的原因。此外，高BUN降低的患者具有更好的PI6M生存率。 ？ 2012年日本老年医学会。

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