Department of Internal Medicine, Mbarara Regional Referral Hospital, Faculty of Medicine, Mbarara University of Science and Technology, Uganda.
Am J Trop Med Hyg. 2011 Oct;85(4):697-702. doi: 10.4269/ajtmh.2011.10-0692.
We evaluated the association between severity of sepsis and in-hospital mortality in 150 patients with non-surgical sepsis at a regional referral hospital in Uganda. In-hospital mortality occurred in 5 of 52 (9.6%) patients with sepsis, 24 of 71 (33.8%) patients with severe sepsis, and 16 of 27 (59.3%) patients with septic shock. In the multivariate analysis, the identification of severe sepsis (adjusted hazard ratio [AHR] = 2.9, 95% confidence interval [CI] = 1.0-8.2, P = 0.04), septic shock (AHR = 5.7, 95% CI = 1.6-20.3, P = 0.007), and dysfunction of three or more organs (AHR = 2.9, 95% CI = 1.1-7.3, P = 0.03) increased the risk of in-hospital mortality. Adding aggregate organ dysfunction to the multivariate equation that included the sepsis category statistically significantly improved the model, but the opposite did not. Predictors of mortality were easily measurable and could be used to risk stratify critically ill patients in resource-constrained settings.
我们评估了在乌干达一家地区转诊医院的 150 名非外科脓毒症患者中，脓毒症严重程度与住院死亡率之间的关系。在 52 名脓毒症患者中有 5 名（9.6%）、71 名严重脓毒症患者中有 24 名（33.8%）和 27 名感染性休克患者中有 16 名（59.3%）发生院内死亡。在多变量分析中，严重脓毒症的识别（调整后的危险比 [AHR] = 2.9，95%置信区间 [CI] = 1.0-8.2，P = 0.04）、感染性休克（AHR = 5.7，95% CI = 1.6-20.3，P = 0.007）和三个或更多器官功能障碍（AHR = 2.9，95% CI = 1.1-7.3，P = 0.03）增加了住院死亡率的风险。将总体器官功能障碍添加到包含脓毒症类别的多变量方程中统计学上显著改善了模型，但反之则不然。死亡率的预测指标易于测量，可以用于对资源有限环境中危重症患者进行风险分层。
