老年危重症患者死亡危险因素分析

Analysis of the Death of Risk Factors in Elderly Patients with Critical Disease

目的探讨老年危重症患者死亡的危险因素,以提高诊治质量。方法回顾性分析2005-2010年重症监护病房(ICU)收治老年患者1004例,142例于ICU死亡,106例出ICU后死亡,对142例患者行年龄分组统计处理,并调查疾病分布特点;将ICU内、外器官功能衰竭数与病死率行对比研究,检验各种危险因素对死亡影响。结果老年患者随年龄增长病死率呈增高趋势;发生功能障碍器官数与病死率密切相关,功能障碍器官数越多,病死率越高;当有5个或5个以上器官发生功能障碍时,病死率接近100%。从器官功能障碍分布来看,心血管系统功能障碍发生率高达41.3%,病死率却低;致死性最高的功能障碍器官是:血液(65.3%)、肾(61.3%);ICU内外致死的障碍功能器官不同。结论老年危重病患者的重点疾病是呼吸系统和神经系统疾病(主要是脑血管疾病),积极治疗原发病的同时需注意保护各脏器功能,早期预防MOFE的发生。

Objective To explore risk factors of death in elderly patients with critical disease, and improve diagnosis and treatment levels Methods 1004 elderly patients who were enrolled in ICU ward during the period of 2005 to 2010 were retrospectively analysed. In 1004 patients, 142 ICU death, 106 post-ICU death According to the differentation of age, analysis 142 cases and investigate characteristic of disease distribu-tion. In addition to, exam effect of different risk factors for death by comparing association between death rate and number of organ failure. Results The death rate in elderly was higher and higher following aging. The age was higher, the death rate was more increase. Organ failure numbers were correlated with death rate which were close to 100% when there were more than five organs dysfunction. According to the distribution of organ dysfunction, cardiovascular failure rate was the highest（41.3%）, whereas the death rate was lower. The highest organs dysfunction due to death were blood（65.3%） and kidney （61.3%）. The organs failure of death were different between in ICU and post-ICU. Conclusion The most important disease of elderly critical patients are respiratory system and nervous system diseases When treating the original disease actively, it is vital to protect organs＇ function in order to prevent MOFE in early stage.