探討呼吸照護病房病患身體質量指數與存活率之相關性

The study of the correlation between body mass index and survival rate of patients in the respiratory care ward

盧靜詩(Ching-Shih Lu)

指導教授 ： 徐成金

中山醫學大學/健康管理學院/營養學系碩士班/碩士(2010年)

摘要

本研究的目的為探討中台灣某醫院自2004年1月起至2009年12月間因需要長期依賴呼吸器而入住呼吸照護病房(respiratory care ward, RCW)之病患，其身體質量指數與存活率之間的相關性。本實驗是採取觀察型回溯性病例對照研究，資料收集包括紀錄並分析研究對象之體重、年齡、性別、身體質量指數(body mass index, BMI)、存活率、生化檢驗值及入住RCW總天數。以BMI值為分組依據，將組別分為體重過輕組（BMI < 18.5 kg/m2）、正常組（BMI < 18.5~23.9 kg/m2）、過重組（BMI < 24 ~ 26.9 kg/m2）、肥胖組（BMI > 27 kg/m2）等4組。而本實驗中存活的定義是指成功脫離呼吸器且由RCW轉出到一般病房、轉居家照護、轉院或至2009年12月31日為止仍未轉出RCW之病患。而於RCW死亡、回轉ICU後死亡、病危自動離院者則視為非存活。本實驗中利用獨立樣本T檢定對存活者與非存活者之年齡、BMI值、入住RCW總天數進行比較分析。利用Pearson chi-square分析存活者及非存活者之性別是否與成功脫離呼吸器之相關性。利用邏輯式回歸分析4組BMI值與存活率之回歸關係。實驗結果發現4組中，體重過重組之存活率會高於體重正常組，但在統計上並無顯著差異。而在生化檢驗值中，albumin對存活之影響顯示，當albumin 增加可顯著的增加病患的存活機會；體重過輕組脫離呼吸器失敗的機會也顯著的高於體重正常組22.4%，體重過重組脫離呼吸器失敗的機會則有低於體重正常組的趨勢。因此本實驗結果證實呼吸照護病房病患體重過重者可增加脫離呼吸器的機會，且有降低死亡率的趨勢。

關鍵字

呼吸照護病房 ； 身體質量指數 ； 存活率 ； 呼吸衰竭

並列摘要

The purpose of this study was to investigate the relationship between the body mass index (BMI) and survival rate of patients with long-term mechanical ventilation support in a respiratory care ward (RCW) from January 2004 to December 2009 in a hospital of central Taiwan.
This is an observational retrospective case-control study, we retrospectively collected data from the patients with long-term mechanical ventilation support in RCW. The information regarding BMI, age, gender, survival rate, laboratory data and duration stay in RCW were used for analyses. According to BMI, the patients are classified into four groups--- underweight (BMI <18.5 kg/m2), normal (18.5-23.9 kg/m2), overweight (24-26.9 kg/m2) and obese (BMI ≧27 kg/m2) groups. The definition of survival referred to weaning ventilation support and transferring to outside general ward, home care, or to another hospital or still stay in the RCW.
Results showed that the survival rate of overweight group was higher than normal group, but there was no significantly difference. The value of albumin was positively correlated with survival rate. The failure rate for weaning ventilation support in overweight group was lower than the normal group. Therefore, this study demonstrated that respiratory care ward patients who were overweight might have higher the ventilator weaning rate and have lower mortality trends.

並列關鍵字

respiratory care ward ； body mass index ； survival rate ； respiratory failure

參考文獻

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