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A population-based observational study of patients with pulmonary disorders in intensive care unit

Korean Journal of Internal Medicine 2020년 35권 6호 p.1411 ~ 1423
이현우, 지은정, 안소연, 양혜주, 윤서영, 박태연, 이연주, 이진우, 이상민, 최승혜, 조영재,
소속 상세정보
이현우 ( Lee Hyun-Woo ) - Seoul National University Hospital Department of Internal Medicine
지은정 ( Ji Eun-Jeong ) - Seoul National University Bundang Hospital Medical Research Collaborating Center
안소연 ( Ahn So-Yeon ) - Seoul National University Bundang Hospital Medical Research Collaborating Center
양혜주 ( Yang Hye-Joo ) - Seoul National University Bundang Hospital Department of Internal Medicine
윤서영 ( Yoon Seo-Young ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Interdepartment of Critical Care Medicine
박태연 ( Park Tae-Yeon ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Interdepartment of Critical Care Medicine
이연주 ( Lee Yeon-Joo ) - Seoul National University Bundang Hospital Department of Internal Medicine
이진우 ( Lee Jin-Woo ) - Seoul National University Hospital Department of Internal Medicine
이상민 ( Lee Sang-Min ) - Seoul National University College of Medicine Department of Internal Medicine
최승혜 ( Choi Seung-Hye ) - Gachon University College of Nursing
조영재 ( Cho Young-Jae ) - Seoul National University Bundang Hospital Department of Internal Medicine

Abstract


Background/Aims: Only a few epidemiologic studies on the patients with pulmonary disorders admitted to intensive care unit exist. We investigated the characteristics and clinical outcomes of the patients with severe pulmonary disorders.

Methods: The sample cohort database of National Health Insurance Sharing Service from 2006 to 2015 was used. Operational definition of critically ill patients was adults who were either admitted to intensive care unit for at least 3 days or expired within first 2 days in the unit. The pulmonary disorder group comprised of critically ill patients with respiratory disease as the main diagnosis.

Results: Among the 997,173 patients, 12,983 (1.3%) in 383 intensive care units were categorized as critically ill. Patients in the pulmonary disorder group tended to have more comorbidities or disabilities. The length of hospital stay and duration of mechanical ventilation were longer in the pulmonary disorder group. Overall mortality and re-admission were higher in the pulmonary disorder group, with adjusted incidence rate ratios of 1.22 (95% confidence interval, 1.18 to 1.27) and 1.26 (95% confidence interval, 1.17 to 1.36), respectively. After adjustment by Cox regression, the pulmonary disorder group was an independent risk factor for in-hospital mortality.

Conclusions: In critically ill patients with pulmonary disorder, the use of healthcare resources was higher, and their clinical outcomes were significantly worse than the non-pulmonary disorder group.

키워드

Critical illness; Lung diseases; Intensive care units; Patient readmission; Mortality

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