Moon Kyoung Min, Han Min Soo, Rim Ch'ang Bum, Lee Jun Ho, Kang Min Seok, Kim Ji Hye, Kim Sang Il, Jung Sun Young, Cho Yongseon
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Tuberc Respir Dis (Seoul). 2016 Jan;79(1):31-6. doi: 10.4046/trd.2016.79.1.31. Epub 2015 Dec 31.
The purpose of this study was to evaluate the risk factors for mechanical ventilation in the patients with scrub typhus admitted to intensive care unit (ICU) at a university hospital.
We retrospectively selected and analyzed clinical data from the medical records of 70 patients (32 men, 38 women) admitted to the ICU with scrub typhus between 2004 and 2014. The patients had a mean±standard deviation age of 71.2±11.1 years and were evaluated in two groups: those who had been treated with mechanical ventilation (the MV group, n=19) and those who had not (the non-MV group, n=51). Mean ages of the MV group and the non-MV group were 71.2±8.3 years and 71.2±11.1 years, respectively.
Significant differences between the two groups were observed with respect to acute respiratory failure (p=0.008), Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.015), Sequential Organ Failure Assessment (SOFA) score (p=0.013), death (p=0.014), and ICU duration (p<0.01). Multivariate analysis indicated that the following factors were significantly associated with mechanical ventilation: acute respiratory failure (p=0.011), SOFA score (p=0.005), APACHE II score (p=0.011), platelet count (p=0.009), and lactate dehydrogenase (LDH) (p=0.011).
Thus, five factors-acute respiratory failure, SOFA score, APACHE II score, platelet count, and LDH-can be the meaningful indicators for mechanical ventilation for the patients with scrub typhus admitted to ICU.
本研究旨在评估某大学医院重症监护病房(ICU)收治的恙虫病患者机械通气的危险因素。
我们回顾性选取并分析了2004年至2014年间入住ICU的70例恙虫病患者(32例男性,38例女性)的病历临床资料。患者的平均年龄±标准差为71.2±11.1岁,分为两组进行评估:接受机械通气治疗的患者(机械通气组,n = 19)和未接受机械通气治疗的患者(非机械通气组,n = 51)。机械通气组和非机械通气组的平均年龄分别为71.2±8.3岁和71.2±11.1岁。
两组在急性呼吸衰竭(p = 0.008)、急性生理与慢性健康状况评分系统(APACHE)II评分(p = 0.015)、序贯器官衰竭评估(SOFA)评分(p = 0.013)、死亡(p = 0.014)以及ICU住院时间(p < 0.01)方面存在显著差异。多因素分析表明,以下因素与机械通气显著相关:急性呼吸衰竭(p = 0.011)、SOFA评分(p = 0.005)、APACHE II评分(p = 0.011)、血小板计数(p = 0.009)和乳酸脱氢酶(LDH)(p = 0.011)。
因此,急性呼吸衰竭、SOFA评分、APACHE II评分、血小板计数和LDH这五个因素可作为入住ICU的恙虫病患者机械通气的有意义指标。