Ishod liječenja bolesnika starije životne dobi oboljelih od teških infekcija u jedinici intenzivne medicine

doctoral thesis

• Title (english): Outcome of treatment of elderly patients suffering from severe infections in the intensive care unit
• Author: Marija Santini; MBZ: 271523
• Mentor: Bruno Baršić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2011-12-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Uvod: Stariji bolesnici predstavljaju rastući udio bolesnika u jedinicama intenzivne
medicine (JIM). Malo je poznato o utjecaju dobi na korištenje resursa JIM i ishod
liječenja, osobito za teške infekcije. ----- Cilj: Istražiti utjecaj dobi na korištenje resursa
JIM i mortalitet. ----- Ustroj: Retrospektivno, kohortno istraživanje. ----- Mjesto: JIM Klinike
za infektivne bolesti u Zagrebu. ----- Bolesnici: Teška infekcija, ≥18 godina, 1994. – 2008.
god. ----- Metode: Uni i bivarijatne analize, multivarijatna analiza. ----- Varijable ishoda:
Učestalost i trajanje mehaničke ventilacije (MV), trajanje JIM liječenja, bolničke
infekcije, preživljenje (opće, 30‐dnevno, rizik za smrtni ishod u prvih 5 tjedana).
----- Rezultati: Od uključenih 2.152 bolesnika, 53.1% bili su ≥60 godina. Multivarijatna
analiza pokazuje da je starija dob neovisni rizični čimbenik (RČ) za češću MV i dulju
MV i dulje liječenje u JIM. Bivarijatna analiza pokazuje da stariji bolesnici imaju
značajno više bolničkih sepsi, bez razlika u učestalosti pneumonija. Multivarijatna
analiza za sve uključene pokazuje da je dob neovisni RČ za ukupnu smrtnost, 30‐dnevno preživljenje te rizik smrti u prvih 5 tjedana, ali isto nije identificirala samo za
MV. ----- Zaključak: Starija dob povećava korištenje resursa JIM, značajan je rizični
čimbenik za smrtni ishod intenzivnog liječenja, ako promatramo sve čimbenike, ali
ako promatramo samo MV, onda težina osnovne bolesti nadvladava utjecaj dobi.

Abstract (english)

Introduction: Elderly represent a growing proportion of intensive care units (ICU)
patients. Little is known about impact of age on ICU utilisation and outcomes,
especially for severe infections. ----- Objective: To assess influence of age on ICU
resource utilisation and mortality. ----- Design: Retrospective, cohort study. Setting: ICU,
University Hospital for Infectious Diseases, Zagreb. ----- Patients: Severe infections, ≥ 18
years, 1994 ‐ 2008. ----- Methods: Uni and bivariate analysis, multivariate analysis.
----- Outcomes: Frequency and duration of mechanical ventilation (MV), ICU treatment
duration , nosocomial infections, survival (overall, 30‐day, risk of fatal outcome
during first 5 weeks). ----- Results: 2152 patients included, 53.1% ≥60 years. Multivariate
analysis ‐ older age is an independent risk factor (RF) for more frequent and
prolonged MV and longer ICU treatment. Bivariate analysis ‐ elderly have more
frequent hospital sepsis, without difference in pneumonia. Multivariate analysis for
all included ‐ age is an independent RF for overall mortality, 30‐day survival and risk
of death within first 5 weeks, does not identify this separately for MV patients.
----- Conclusion: Older age increases utilization of ICU resources and is a RF for fatal ICU
outcome, if all ICU patients considered. But if only MV considered, weight of
underlying disease overcomes influence of age.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:456022
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 70 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 06:44:45