身體質量指數對內科加護中心患者預後之探討

目的：探討身體質量指數(body mass index, BMI)對內科加護病房預後之關係，希望藉由早期的BMI評估其預後，並做適當的醫療照護。方法：本研究採回溯性調查，收集2005年6月至2006年4月醫學中心內科加護病房的340名患者。依BMI分爲低體重、正常組和肥胖組等三組，探討BMI對ICU預後包括疾病嚴重度、ICU住院天數、使用呼吸器天數、呼吸器依賴百分比及死亡率。結果：本研究以肺部疾病爲主（213位，62.7%）。肥胖組在ICU住院天數及APACHE Ⅱ score雖高於正常組及低體重組，但並不具統計意義。肥胖組之死亡率高於正常組及低體重組(19.7% vs. 14.7% vs. 8.8%)。在呼吸器依賴的百分比，肥胖組與低體重組高於正常組(18% vs. 14.7% vs. 11.4%)。結論：BMI與疾病嚴重度、ICU住院天數、使用呼吸器天數無關，但肥胖組的死亡率及呼吸器依賴的百分比高於正常組。身體質量指數雖不能準確預測內科加護病房病患預後的指標，但仍是可信賴的參考數據。

關鍵字

身體質量指數；死亡率；呼吸器依賴；預後

並列摘要

Objectives: The major purpose of this study was to investigated the relation between the body mass index (BMI) and outcomes of patients in medical intensive care unit (MICU). Methods: This is a retrospective study. From June 2004 to April 2005, we retrospectively collected data from 340 patients with mechanical ventilation support in a MICU. All patients into classified the BMI was divided into 3 groups (underweight, BMI＜18.5; normal, ＜18.5BMI＜25; and obesity BMI≧25), and their outcome including: mortality rate, APACHE Ⅱ score, ICU length of stay, ventilator day, ventilator-dependent rate were also collected from medical charts. Results: The most diagnosis was pulmonary disease (213 cases, 62.7%), we found obesity patients length of stay, APACHE Ⅱ score higher than normal and underweight group, but showed no statistical significance. However, mortality rate in the obesity patients higher than normal and underweight group (19.7% vs. 14.7% vs. 8.8% respectively). In addition the rate of ventilator dependent was showed higher in the obsess and underweight patients that in normal BMI (18%, vs. 14.7% vs. 11.4% respectively). Conclusions: There were no differences in APACHE score, ICU length of stay, ventilator day in the three group, The BMI per se did not predict patients in the MICU outcomes. The obese patients had higher incidences of ventilator-dependent and obese patients mortality rate higher than normal and underweight patients group.

並列關鍵字

Body mass index ； Mortality rate ； Ventilator-dependent ； Outcomes

被引用紀錄

林淑湄（2011）。熱量調整對長期使用呼吸器病人之影響〔碩士論文，中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834/CSMU.2011.00093

廖翎聿（2017）。慢性阻塞性肺病住院老人之心肺耐力相關影響因素探討〔博士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2812201719232200

延伸閱讀

高婷婷、吳玫錚、黃梅菊、吳重慶（2006）。加護病房內患者身體約束護理記錄之改善方案。秀傳醫學雜誌，6(1&2)，51-60。https://www.airitilibrary.com/Article/Detail?DocID=15610497-200604-6-1&2-51-60-a
黃美凰（2007）。讚美策略融入技能教學之成效研究－以護理科身體評估課程爲例。人文社會科學研究，1(2)，40-58。https://doi.org/10.6284/NPUSTHSSR.2007.1(2)3
林雅雯、鍾玉珠（2020）。醫院護理主管領導行為、團隊健康氣候及護理人員職場幸福感之多層次研究：護理人員健康行為之中介效果驗證。台灣公共衛生雜誌，39(5)，565-577。https://doi.org/10.6288/TJPH.202010_39(5).109059
Cheng, C. C., Huang, W. C., Chiou, K. R., Kuo, F. Y., Chiang, C. H., Yang, J. S., Lin, K. L., Hsiao, S. H., Hwang, H. R., Mar, G. Y., Lin, S. L., Chiou, C. W., & Liu, C. P. (2013). Body Mass Index and Outcome of Acute Myocardial Infarction-Is There an Obesity Paradox?. Acta Cardiologica Sinica, 29(5), 413-420. https://www.airitilibrary.com/Article/Detail?DocID=10116842-201309-201309180030-201309180030-413-420
吳一德、胡巧欣、吳志銘（2009）。The Study of Relationship between Body Mass Index and Metabolic Syndrome in University Freshmen。運動休閒餐旅研究，4(2)，1-16。https://doi.org/10.29429/JSLHR.200906_4(2).01

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身體質量指數對內科加護中心患者預後之探討

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