Rehabilitation is Associated with Lower Mortality in Patients with Dengue Fever in Intensive Care Units: A Retrospective Study

復健與加護病房內登革熱病人較低的死亡率相關－回溯性研究

程信翰(Hsin-Han Cheng) ； 陳欽明(Chin-Ming Chen) ； 周偉倪(Willy Chou)

《台灣復健醫學雜誌》 48卷2期 (2020/12) Pp. 105-111

https://doi.org/10.6315/TJPMR.202012_48(2).0004

摘要

Objective: The study aimed to examine the effect of rehabilitation on mortality in patients with dengue in intensive care units (ICUs). Design: This was a retrospective cohort study. In this study, 142 patients with dengue from ICUs were enrolled from August to December, 2015. They were divided into two groups: patients with or without rehabilitation. The relationship between rehabilitative therapy and the risk of dengue-related mortality was assessed using a multivariate Cox regression model after adjustment for related variables. Results: Of the 142 patients, 70 (49.3%) were men, and the mean age was 69.97 ± 15.93 years. The average length of stay in the hospital was 14.79 ± 16.14 days. The results of the Cox regression indicated that rehabilitated patients had a lower risk of dengue-related mortality [adjusted hazard ratio (HR) = 0.196; 95% confidence interval (CI) = 0.059-0.656]. Conclusion: Rehabilitation was found to be associated with lower risk of mortality in patients with dengue fever in the ICUs. More randomized control trials are required to consolidate the effect.

關鍵字

rehabilitation ； intensive care unit(ICU) ； mortality ； dengue

並列摘要

研究目的：研究復健對於因登革熱重症進入加護病房病人死亡率的影響。研究設計：本研究為回溯性世代追蹤研究。收案期間自2015年8月至12月，共有142位病人因登革熱重症進入加護病房。透過資料回溯復健的有無，將病人族群分成復健組與無復健組，並進行相關的資料分析。其中，使用Cox迴歸分析顯著影響死亡率的變數。結果：142位病人平均年齡為69.97 ± 15.93歲，70位病人（49.3％）為男性，平均待在住院時間為14.79 ± 16.14天。Cox迴歸分析發現有復健的登革熱重症族群死亡的風險比（hazard ratio, HR）為0.196（95％信賴區間為0.059 - 0.656）。結論：復健與加護病房內登革熱病人較低的死亡率相關。未來需要更進一步的隨機對照試驗去確定此一研究的因果關係。

並列關鍵字

復健（rehabilitation） ； 重症加護病房（ICU） ； 死亡率（mortality） ； 登革熱（dengue）

參考文獻

Amancio FF, TP Heringer, C de Oliveira Cda, et al. Clinical Profiles and Factors Associated with Death in Adults with Dengue Admitted to Intensive Care Units, Minas Gerais, Brazil. PLoS One 2015;10(6):e0129046.

Chen CM, KS Chan, WL Yu, et al. The outcomes of patients with severe dengue admitted to intensive care units. Medicine (Baltimore) 2016;95(31):e4376.

Pandharipande P, A Banerjee, S McGrane, et al. Liberation and animation for ventilated ICU patients: the ABCDE bundle for the back-end of critical care. Crit Care 2010;14(3):157.

Morandi A, NE Brummel, EW Ely. Sedation, delirium and mechanical ventilation: the 'ABCDE' approach. Curr Opin Crit Care 2011;17(1):43-9.

Bienvenu OJ, E Colantuoni, PA Mendez-Tellez, et al. Cooccurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study. Crit Care Med 2015;43(3):642-53.