Dept of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de lennik 808, Brussels, Belgium.
Crit Care. 2010;14(2):R32. doi: 10.1186/cc8909. Epub 2010 Mar 15.
There are few data related to the effects of different sources of infection on outcome. We used the Sepsis Occurrence in Acutely ill Patients (SOAP) database to investigate differences in the impact of respiratory tract and abdominal sites of infection on organ failure and survival.
The SOAP study was a cohort, multicenter, observational study which included data from all adult patients admitted to one of 198 participating intensive care units (ICUs) from 24 European countries during the study period. In this substudy, patients were divided into two groups depending on whether, on admission, they had abdominal infection but no respiratory infection or respiratory infection but no abdominal infection. The two groups were compared with respect to patient and infection-related characteristics, organ failure patterns, and outcomes.
Of the 3,147 patients in the SOAP database, 777 (25%) patients had sepsis on ICU admission; 162 (21%) had abdominal infection without concurrent respiratory infection and 380 (49%) had respiratory infection without concurrent abdominal infection. Age, sex, and severity scores were similar in the two groups. On admission, septic shock was more common in patients with abdominal infection (40.1% vs. 29.5%, P = 0.016) who were also more likely to have early coagulation failure (17.3% vs. 9.5%, P = 0.01) and acute renal failure (38.3% vs. 29.5%, P = 0.045). In contrast, patients with respiratory infection were more likely to have early neurological failure (30.5% vs. 9.9%, P < 0.001). The median length of ICU stay was the same in the two groups, but the median length of hospital stay was longer in patients with abdominal than in those with respiratory infection (27 vs. 20 days, P = 0.02). ICU (29%) and hospital (38%) mortality rates were identical in the two groups.
There are important differences in patient profiles related to the site of infection; however, mortality rates in these two groups of patients are identical.
关于不同感染源对预后影响的数据很少。我们使用 Sepsis Occurrence in Acutely ill Patients（SOAP）数据库来研究呼吸道和腹部感染部位对器官衰竭和存活的影响差异。
SOAP 研究是一项队列、多中心、观察性研究，纳入了来自 24 个欧洲国家的 198 家参与 ICU 的所有成年患者的数据。在这项子研究中，根据患者入院时是否有腹部感染但无呼吸道感染或有呼吸道感染但无腹部感染，将患者分为两组。比较两组患者的患者和感染相关特征、器官衰竭模式和结局。
在 SOAP 数据库的 3147 例患者中，777 例（25%）患者在 ICU 入院时患有败血症；162 例（21%）有腹部感染但无同时存在的呼吸道感染，380 例（49%）有呼吸道感染但无同时存在的腹部感染。两组患者的年龄、性别和严重程度评分相似。入院时，有腹部感染的患者发生感染性休克更为常见（40.1% vs. 29.5%，P = 0.016），也更有可能早期发生凝血功能障碍（17.3% vs. 9.5%，P = 0.01）和急性肾功能衰竭（38.3% vs. 29.5%，P = 0.045）。相比之下，有呼吸道感染的患者更有可能出现早期神经系统衰竭（30.5% vs. 9.9%，P < 0.001）。两组患者的 ICU 住院时间中位数相同，但有腹部感染的患者的住院时间中位数比有呼吸道感染的患者长（27 天 vs. 20 天，P = 0.02）。两组患者的 ICU 死亡率（29%）和医院死亡率（38%）相同。
与感染部位相关的患者特征存在重要差异；然而，这两组患者的死亡率相同。
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