지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 46 - 52 (7page)
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초록· 키워드
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Background:Admission of patients perceived as potentially inappropriate for intensive care is a very sensitive and controversial issue. We aimed to evaluate the use of medical resources in the intensive care unit (ICU) and outcomes of patients according to a physician’s judgment of appropriateness. Methods:ICU physicians classified patients who were admitted to the medical ICU of a tertiary hospital as appropriate or inappropriate for intensive care within 24 hours of admission. Patient outcomes including mortality were analyzed according to appropriateness. Additionally, the usage and duration of mechanical ventilation (MV), renal replacement therapy (RRT), and extracorporeal membrane oxygenation (ECMO) were analyzed according to appropriateness. Results:In total, 105 patients (male, 55.4%; mean age, 62 years) were included. Twelve (11.4%) patients were considered inappropriate for intensive care based on guidance published by the Society of Critical Care Medicine through a questionnaire survey of physicians. There was no significant difference between patients considered inappropriate or appropriate for ICU admission regarding the use and duration of MV, RRT, and ECMO. In contrast, the ICU, in-hospital, 28-day, 90-day, and total mortality rates were significantly higher among patients with inappropriate admission than among patients with appropriate admission (ICU mortality: 50.0% vs. 25.8%, P=0.008; in-hospital mortality: 58.3% vs. 43.0%, P=0.028; 28-day mortality: 58.3% vs. 33.3%, P=0.019; 90-day mortality: 66.7% vs. 44.1%, P=0.023). Conclusions:Despite higher mortality, the amount of medical resources used for patients considered potentially inappropriate for intensive care did not differ from the resources used for patients considered suitable for ICU care.
목차
등록된 정보가 없습니다.
참고문헌 (19)
참고문헌 신청
Huynh TN / 2014 / The opportunity cost of futile treatment in the ICU / Crit Care Med 42:1977~1982
Angus DC / 2004 / Use of intensive care at the end of life in the United States : an epidemiologic study / Crit Care Med 32:638~643
Riley GF / 2010 / Long-term trends in Medicare payments in the last year of life / Health Serv Res 45:565~576
Neville TH / 2017 / Blood products provided to patients receiving futile critical care / J Hosp Med 12:739~742
Huynh TN / 2013 / The frequency and cost of treatment perceived to be futile in critical care / JAMA Intern Med 173:1887~1894
Angus DC / 2004 / Use of intensive care at the end of life in the United States : an epidemiologic study / Crit Care Med 32:638~643
Riley GF / 2010 / Long-term trends in Medicare payments in the last year of life / Health Serv Res 45:565~576
Neville TH / 2017 / Blood products provided to patients receiving futile critical care / J Hosp Med 12:739~742
Huynh TN / 2013 / The frequency and cost of treatment perceived to be futile in critical care / JAMA Intern Med 173:1887~1894
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