Functional outcome after critical illness in older patients: a population-based study

To determine the prevalence of disability among ICU survivors one year after admission, and which factors influence functional outcome. We examined consecutive patients enrolled in the population-based Mayo Clinic Olmsted Study of Aging and then admitted to medical or surgical adult ICUs at Mayo Clinic, Rochester between January 1, 2006, and December 31, 2014 to determine one-year functional outcomes. 831cases were included. Mean age was 84 years (IQR 79–88). 569 (68.5%) patients were alive one year after ICU admission. Of them, 546 patients had functional assessment at one year and 367 (67.2%) had good functional outcome. On multivariable analysis, poor one-year functional outcome (death or disability) was more common among women, older patients, and patients with baseline cognitive impairment (mild cognitive impairment or dementia), higher Carlson scores, and longer ICU stay (all P On a population-based cohort of older, predominantly elderly patients, approximately two-thirds of survivors maintained or regained good functional status 1 year after ICU hospitalization. However, older age, female sex, greater comorbidities, abnormal baseline cognition, and longer ICU stay were associated with poor functional recovery and cognitive decline was common.

为明确重症监护病房（Intensive Care Unit, ICU）患者入院1年后的残疾患病率及功能结局的影响因素，本研究纳入2006年1月1日至2014年12月31日期间，入住罗切斯特梅奥诊所成人内科/外科重症监护病房且已加入基于人群的梅奥诊所奥姆斯特德衰老研究的连续病例，对其1年功能结局展开分析。本研究共纳入831例患者，平均年龄为84岁（四分位间距（Interquartile Range, IQR）79~88）。其中569例（68.5%）患者在ICU入院后1年仍存活。在存活患者中，546例完成了1年功能评估，367例（67.2%）具备良好功能结局。多变量分析显示，1年功能结局较差（死亡或存在残疾）在女性、高龄患者、基线认知功能受损（轻度认知障碍或痴呆）、卡尔森（Carlson）合并症评分更高以及ICU住院时间更长的患者中更为常见（所有P值均<0.05）。本研究的人群队列以老年患者为主，约三分之二的ICU住院幸存者在入院1年后维持或恢复了良好的功能状态。然而，高龄、女性性别、合并症更严重、基线认知功能异常以及ICU住院时间更长均与较差的功能恢复相关，且认知衰退现象较为普遍。