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[求助]
请问许多文章中所述limitations of medical treatment（LOMT）是什么意思
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请不要直译LOMT为“临床治疗限制性”或内科治疗限制性”。请详细说说LOMT的具体意思。是因为禁忌症不能应用RRT？还是因为什么原因？请指教！谢谢啦！ 如附件文章中所述。相关网址http://ndt.oxfordjournals.org/content/27/3/947.long 题目：Severe acute kidney injury not treated with renal replacement therapy: characteristics and outcome. 部分内容如下： Within the study period, 20 126 patients were admitted to our institution for >24 h. Among them, 2949 were admitted to the intensive care unit (ICU) and 195 developed RIFLE-F AKI. Of these, 90 received RRT (RRT patients) and 105 did not (no-RRT patients). Compared with RRT patients, no-RRT patients were similar in terms of age, gender and ward of origin. However, they had a shorter median ICU stay (2.7 versus 7.9 days; P < 0.001), required less mechanical ventilation (56.2 versus 70%; P < 0.05) and had a lower mean Acute Physiology and Chronic Health Evaluation III score (82.7 versus 86.7; P < 0.05). The two main reasons these patients did not receive RRT were limitations of medical therapy (LOMT) orders in 41 (39%) cases and expected renal functional improvement in 59 (56.2%). Mortality in no-RRT patients was 58.1% compared with 55.5% in the RRT group (P = 0.72). After exclusion of LOMT patients, the mortality of the no-RRT group, although lower than that of the RRT group, remained high (30.5 versus 55%; P < 0.001). Most of these deaths occurred after ICU discharge and appeared secondary to underlying chronic diseases or recurrence of the initial insult. Reason for no RRT. Similarly, on chart review, the researcher classified the reason why no RRT was undertaken. Five a priori categories were defined: limitations of medical therapy (LOMT), recovery of renal function, transfer to another hospital, death before initiation of RRT and other. The ‘recovery of renal function’ category referred to cases where the clinicians estimated that the patient’s condition was not sufficient to trigger RRT and/or they presented signs of renal recovery (increased urinary output, improved hemodynamic status), which justified continued observation without the application of RRT. |
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2014-03-09 08:11:09, 182.68 K
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