Intens Care Med:重症监护患者精神疾病分析

2019-09-18 xing.T MedSci原创

由此可见,ICU与住院后精神疾病诊断风险略有增加相关,当考虑入院原因时往往不再明显。机械通气或ICU停留时间较长的患者后续发生精神疾病的风险可能较高。

危重病幸存者可能面临后续发展为精神疾病的高风险。近日,危重病医学领域权威杂志Intensive Care Medicine上发表了一篇研究文章,研究人员试图确定与住院患者相比,重症监护病房(ICU)幸存者的新发精神疾病诊断的风险。

研究人员在加拿大安大略省住院的成人中进行了基于人群的研究(2005-2015)。该研究的主要暴露是ICU入院≥48小时;次要暴露是ICU内操作,包括机械通气和ICU持续时间。该研究的主要结局是出院后一年内诊断出的精神疾病。为了解释ICU与其他住院患者之间的病例组合差异,研究人员进行了敏感性分析,但限制为预先确定6种诊断,无论是否入住ICU,都需要住院治疗。

1847462例患者住院治疗后幸存,其中121101例住院ICU≥48小时,与住院患者相比,ICU患者出院后一年内新发精神疾病诊断率更高(17% vs. 15%,校正风险比(aHR)为1.08,95%CI为1.07-1.10)。在仅限于预先指定的诊断分析中,与ICU相关的风险增加仅在肺炎患者中具有显著性。在ICU幸存者中,暴露于机械通气(aHR:1.08; 95%CI为1.05-1.12)或更长的ICU住院时间(每天aHR:1.004; 95%CI为1.003-1.005)增加了新发精神疾病诊断的风险。

由此可见,ICU与住院后精神疾病诊断风险略有增加相关,当考虑入院原因时往往不再明显。机械通气或ICU停留时间较长的患者后续发生精神疾病的风险可能较高。 

原始出处:

Lavarnan Sivanathan,et al.Mental illness after admission to an intensive care unit.Intensive Care Medicine.2019.https://www.esicm.org/icm-search/?id=doi:10.1007/s00134-019-05752-5#article

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