Grozdanovski Krsto, Milenkovic Zvonko, Demiri Ilir, Spasovska Katerina
Department of Intensive Care, University Clinic for Infectious Diseases, Vodnjanska 17, 1000 Skopje, Macedonia.
Crit Care Res Pract. 2012;2012:182324. doi: 10.1155/2012/182324. Epub 2012 Oct 17.
Our aim was to determine the risk factors on mortality in adult patients with community-acquired severe sepsis and septic shock. The main outcome measure was hospital mortality. This prospective single centre study was conducted from January 1, 2008 to December 31, 2010, and included 184 patients, of whom 135 (73.4%) were with severe sepsis and 49 (26.6%) had septic shock. Overall, ninety-five (51.6%) patients have died, 60 (44.4%) in severe sepsis and 35 (71.4%) patients with septic shock. The lung was the most common site of infection 121 (65.8%), and chronic heart failure was the most frequent comorbidity 65 (35.3%). Logistic multivariate analysis identified three independent risk factors for mortality in patients with severe sepsis: positive blood culture (odds ratio, 2.39; 95% confidence interval, 1.13-5.06; P = 0.02), three or more organ dysfunctions (odds ratio, 3.93; 95% confidence interval, 1.62-9.53; P = 0.002), and Simplified Acute Physiology Score (SAPS) II (odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P = 0.01). In addition to SAPS II, positive blood culture, and three or more organ dysfunctions are important independent risk factors for mortality in patients with severe sepsis and septic shock.
我们的目的是确定社区获得性严重脓毒症和脓毒性休克成年患者的死亡风险因素。主要结局指标是医院死亡率。这项前瞻性单中心研究于2008年1月1日至2010年12月31日进行，纳入了184例患者，其中135例（73.4%）为严重脓毒症，49例（26.6%）患有脓毒性休克。总体而言，95例（51.6%）患者死亡，严重脓毒症患者中60例（44.4%）死亡，脓毒性休克患者中35例（71.4%）死亡。肺部是最常见的感染部位121例（65.8%），慢性心力衰竭是最常见的合并症65例（35.3%）。多因素logistic分析确定了严重脓毒症患者死亡的三个独立风险因素：血培养阳性（比值比，2.39；95%置信区间，1.13 - 5.06；P = 0.02）、三个或更多器官功能障碍（比值比，3.93；95%置信区间，1.62 - 9.53；P = 0.002）以及简化急性生理学评分（SAPS）II（比值比，1.02；95%置信区间，1.00 - 1.04；P = 0.01）。除SAPS II外，血培养阳性和三个或更多器官功能障碍是严重脓毒症和脓毒性休克患者死亡的重要独立风险因素。
