PDF(Pubmed)
Abstract：
BACKGROUND: Trauma and emergency surgery are major causes of morbidity and mortality. The objective of this study was to determine whether serum levels of epinephrine and norepinephrine are associated with aging and mortality.
METHODS: This was a prospective observational cohort study conducted in a surgical critical care unit. We included 90 patients who were admitted for postoperative care, because of major trauma, or both. We collected demographic and clinical variables, as well as serum levels of epinephrine and norepinephrine.
RESULTS: For patients in the > 60-year age group, the use of vasoactive drugs was found to be associated with an undetectable epinephrine level (OR [95% CI] = 6.36 [1.12, 36.08]), p = 0.05). For the patients with undetectable epinephrine levels, the in-hospital mortality was higher among those with a norepinephrine level ≥ 2006.5 pg/mL (OR [95% CI] = 4.00 [1.27, 12.58]), p = 0.03).
CONCLUSIONS: There is an association between age and mortality. Undetectable serum epinephrine, which is more common in older patients, could contribute to poor outcomes. The use of epinephrine might improve the clinical prognosis in older surgical patients with shock.
METHODS: This was a prospective observational cohort study conducted in a surgical critical care unit. We included 90 patients who were admitted for postoperative care, because of major trauma, or both. We collected demographic and clinical variables, as well as serum levels of epinephrine and norepinephrine.
RESULTS: For patients in the > 60-year age group, the use of vasoactive drugs was found to be associated with an undetectable epinephrine level (OR [95% CI] = 6.36 [1.12, 36.08]), p = 0.05). For the patients with undetectable epinephrine levels, the in-hospital mortality was higher among those with a norepinephrine level ≥ 2006.5 pg/mL (OR [95% CI] = 4.00 [1.27, 12.58]), p = 0.03).
CONCLUSIONS: There is an association between age and mortality. Undetectable serum epinephrine, which is more common in older patients, could contribute to poor outcomes. The use of epinephrine might improve the clinical prognosis in older surgical patients with shock.
摘要：
背景：创伤和急诊手术是发病率和死亡率的主要原因。这项研究的目的是确定血清肾上腺素和去甲肾上腺素的水平是否与衰老和死亡率相关。
方法：这是一项在外科重症监护病房进行的前瞻性观察性队列研究。我们纳入了90名接受术后护理的患者，因为严重的创伤,或者两者兼而有之。我们收集了人口统计学和临床变量，以及血清肾上腺素和去甲肾上腺素的水平。
结果：对于>60岁年龄组的患者，发现使用血管活性药物与无法检测的肾上腺素水平相关（OR[95%CI]=6.36[1.12,36.08]），p=0.05)。对于肾上腺素水平检测不到的患者，那些去甲肾上腺素水平≥2006.5pg/mL的患者的住院死亡率较高(OR[95%CI]=4.00[1.27,12.58]),p=0.03)。
结论：年龄和死亡率之间存在关联。检测不到血清肾上腺素，这在老年患者中更常见，可能会导致糟糕的结果。使用肾上腺素可以改善老年休克手术患者的临床预后。
方法：这是一项在外科重症监护病房进行的前瞻性观察性队列研究。我们纳入了90名接受术后护理的患者，因为严重的创伤,或者两者兼而有之。我们收集了人口统计学和临床变量，以及血清肾上腺素和去甲肾上腺素的水平。
结果：对于>60岁年龄组的患者，发现使用血管活性药物与无法检测的肾上腺素水平相关（OR[95%CI]=6.36[1.12,36.08]），p=0.05)。对于肾上腺素水平检测不到的患者，那些去甲肾上腺素水平≥2006.5pg/mL的患者的住院死亡率较高(OR[95%CI]=4.00[1.27,12.58]),p=0.03)。
结论：年龄和死亡率之间存在关联。检测不到血清肾上腺素，这在老年患者中更常见，可能会导致糟糕的结果。使用肾上腺素可以改善老年休克手术患者的临床预后。
