Living and dying with chronic obstructive pulmonary disease.
作者： Joanne Lynn , E. Wesley Ely , Zhenshao Zhong , Kristin Landrum McNiff , Neal V. Dawson
DOI: 10.1111/J.1532-5415.2000.TB03147.X
关键词: Intensive care medicine 、 Internal medicine 、 Artificial respiration 、 Exacerbation 、 Quality of life 、 Prospective cohort study 、 Palliative care 、 COPD 、 Medicine 、 Respiratory infection 、 Intensive care
摘要: OBJECTIVE: To characterize chronic obstructive pulmonary disease (COPD) over patients' last 6 months of life. STUDY DESIGN: A retrospective analysis a prospective cohort from the Study to Understand Prognoses and Preferences for Outcomes Risks Treatments (SUPPORT). SETTING: Hospitalization exacerbation COPD at five US teaching hospitals. PARTICIPANTS: patients who died within 1 year (n = 416) among 1016 enrolled. METHODS: Interview medical record data were organized into time windows beginning with death ending earlier. OUTCOME MEASURES: Days in hospital, prognosis, illness severity, function, symptoms, preferences, impacts on families. RESULTS: One-year survival was 59%, 39% had ≥3 comorbidities, 15 25% hospitals. Exacerbation etiologies included respiratory infection (47%) cardiac problems (30%). Better quality life predicted longer (ARR: 0.36; 95% CI, 0.19- 0.87) as did heart failure etiology 0.57; 0.40, 0.82). Estimates by physicians prognostic model well calibrated, although worst prognoses survived than predicted. Patients' estimates prognosis poorly calibrated. One-quarter serious pain throughout, two-thirds dyspnea. illnesses major impact more families. preferences Do-Not-Resuscitate orders increased 40% 3 before 77% month death; their decisions not use mechanical ventilation 12 31%, resuscitation decreased 52 23%. CONCLUSIONS: Patients advanced often die have substantial comorbidities symptoms. Adequate description anchors improved care.
sci-hub.se 参考文章(35)
Millicent W. Higgins, Chronic Airways Disease in the United States: Trends and Determinants Chest. ,vol. 96, pp. 328- ,(1989) , 10.1378/CHEST.96.3_SUPPLEMENT.328S
John L. Moran, John V. Green, Sean D. Homan, Richard J. Leeson, Phillip I. Leppard, Acute exacerbations of chronic obstructive pulmonary disease and mechanical ventilation: a reevaluation. Critical Care Medicine. ,vol. 26, pp. 71- 78 ,(1998) , 10.1097/00003246-199801000-00019
Nathalie Pelletier-Fleury, Jean-Louis Lanoe, Bernard Fleury, Michèle Fardeau, The cost of treating COPD patients with long-term oxygen therapy in a French population. Chest. ,vol. 110, pp. 411- 416 ,(1996) , 10.1378/CHEST.110.2.411
Leonard D. Hudson, Survival data in patients with acute and chronic lung disease requiring mechanical ventilation. The American review of respiratory disease. ,vol. 140, ,(1989) , 10.1164/AJRCCM/140.2_PT_2.S19
WILLIAM A. KNAUS, ELIZABETH A. DRAPER, DOUGLAS P. WAGNER, JACK E. ZIMMERMAN, APACHE II: a severity of disease classification system. Critical Care Medicine. ,vol. 13, pp. 818- 829 ,(1985) , 10.1097/00003246-198510000-00009
William A Knaus, Frank E Harrell, Joanne Lynn, Lee Goldman, Russell S Phillips, Alfred F Connors, Neal V Dawson, William J Fulkerson, Robert M Califf, Norman Desbiens, Peter Layde, Robert K Oye, Paul E Bellamy, Rosemarie B Hakim, Douglas P Wagner, The SUPPORT Prognostic Model: Objective Estimates of Survival for Seriously Ill Hospitalized Adults Annals of Internal Medicine. ,vol. 122, pp. 191- 203 ,(1995) , 10.7326/0003-4819-122-3-199502010-00007
Dirkje S. Postma, Johan B. Wempe, Tineke E. J. Renkema, Thomas W. Van Der Mark, Gerard H. Koëter, Hyperresponsiveness as a determinant of the outcome in chronic obstructive pulmonary disease. The American review of respiratory disease. ,vol. 143, pp. 1458- 1462 ,(1991) , 10.1164/AJRCCM/143.6.1458
A. Sonia Buist, John E. Connett, R. Drew Miller, Richard E. Kanner, Gregory R. Owens, Helen T. Voelker, Chronic Obstructive Pulmonary Disease Early Intervention Trial (Lung Health Study): Baseline characteristics of randomized participants Chest. ,vol. 103, pp. 1863- 1872 ,(1993) , 10.1378/CHEST.103.6.1863
J R Curtis, R A Deyo, L D Hudson, Pulmonary rehabilitation in chronic respiratory insufficiency. 7. Health-related quality of life among patients with chronic obstructive pulmonary disease. Thorax. ,vol. 49, pp. 162- 170 ,(1994) , 10.1136/THX.49.2.162
Alfred F Connors, Neal V Dawson, Norman A Desbiens, William J Fulkerson, Lee Goldman, William A Knaus, Joanne Lynn, Robert K Oye, Marilyn Bergner, Anne Damiano, Rosemarie Hakim, Donald J Murphy, Joan Teno, Beth Virnig, Douglas P Wagner, Albert W Wu, Yutaka Yasui, Detra K Robinson, Barbara Kreling, Jennie Dulac, Rose Baker, Sam Holayel, Thomas Meeks, Mazen Mustafa, Juan Vegarra, Carlos Alzola, Frank E Harrell, E Francis Cook, Mary Beth Hamel, Lynn Peterson, Russell S Phillips, Joel Tsevat, Lachlan Forrow, Linda Lesky, Roger Davis, Nancy Kressin, Jeanmarie Solzan, Ann Louise Puopolo, Laura Quimby Barrett, Nora Bucko, Deborah Brown, Maureen Burns, Cathy Foskett, Amy Hozid, Carol Keohane, Colleen Martinez, Dorcie McWeeney, Debra Melia, Shelley Otto, Kathy Sheehan, Alice Smith, Lauren Tofias, Bernice Arthur, Carol Collins, Mary Cunnion, Deborah Dyer, Corinne Kulak, Mary Michaels, Maureen O'Keefe, Marian Parker, Lauren Tuchin, Dolly Wax, Diana Weld, Liz Hiltunen, Georgie Marks, Nancy Mazzapica, Cindy Medich, Jane Soukup, Robert M Califf, Anthony N Galanos, Peter Kussin, Lawrence H Muhlbaier, Maria Winchell, Lee Mallatratt, Ella Akin, Lynne Belcher, Elizabeth Buller, Eileen Clair, Laura Drew, Libby Fogelman, Dianna Frye, Beth Fraulo, Debbie Gessner, Jill Hamilton, Kendra Kruse, Dawn Landis, Louise Nobles, Rene Oliverio, Carroll Wheeler, Nancy Banks, Steven Berry, Monie Clayton, Patricia Hartwell, Nan Hubbard, Isabel Kussin, Barbara Norman, Jackie Noveau, Heather Read, Barbara Warren, Jane Castle, Kathy Turner, Rosalie Perdue, Claudia Coulton, C Seth Landefeld, Theodore Speroff, Stuart Youngner, Mary J Kennard, Mary Naccaratto, Mary Jo Roach, Maria Blinkhorn, Cathy Corrigan, Elsie Geric, Laura Haas, Jennifer Ham, Julie Jerdonek, Marilyn Landy, Elaine Marino, Patti Olesen, Sherry Patzke, Linda Repas, Kathy Schneeberger, Carolyn Smith, Colleen Tyler, Mary Zenczak, Helen Anderson, Pat Carolin, Cindy Johnson, Pat Leonard, Judy Leuenberger, Linda Palotta, Millie Warren, Jane Finley, Toni Ross, Gillian Solem, Sue Zronek, Sara Davis, Steven Broste, Peter Layde, Michael Kryda, Douglas J Reding, Humberto J Vidaillet, Marilyn Folien, Patsy Mowery, Barbara E Backus, Debra L Kempf, Jill M Kupfer, Karen E Maassen, Jean M Rohde, Nancy L Wilke, …, A controlled trial to improve care for seriously ill hospitalized patients: The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT) JAMA. ,vol. 274, pp. 1591- 1598 ,(1995) , 10.1001/JAMA.274.20.1591