Ni Hai-Bin, Hu Xing-Xing, Huang Xiao-Fei, Liu Ke-Qin, Yu Chen-Bin, Wang Xiao-Meng, Ke Lu
Department of Emergency, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu Province, China.
Department of Emergency, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu Province, China.
Am J Med Sci. 2016 Jun;351(6):601-5. doi: 10.1016/j.amjms.2016.01.027. Epub 2016 Mar 31.
Hypernatremia is an uncommon but important electrolyte abnormality in intensive care unit patients. Sepsis is one of the most common causes of intensive care unit admission, but few studies about the role of hypernatremia in sepsis has been published yet. In this study, we aimed to explore the risk factors for developing hypernatremia in patients with sepsis, and the prognosis of patients with sepsis with or without hypernatremia was also assessed.
In this retrospective cohort study of 51 septic intensive care unit patients at a single center, we examined the risk factors for the development of hypernatremia and the association of hypernatremia with clinical outcomes using univariate and multivariable analyses. Clinical outcomes such as mortality and hospital duration of patients with or without hypernatremia were also compared.
Acute Physiology and Chronic Health Evaluation II score (odds ratio = 1.15; 95% CI: 1.022-1.294) was found to be the only independent risk factor for hypernatremia in patients with sepsis. Moreover, patients developing hypernatremia during hospitalization showed significantly higher morbidity and mortality.
Acute Physiology and Chronic Health Evaluation II score may be an independent risk factor for hypernatremia in patients with sepsis. Moreover, hypernatremia is strongly associated with worse outcome in sepsis.
高钠血症在重症监护病房患者中虽不常见,但却是一种重要的电解质异常情况。脓毒症是重症监护病房收治患者的最常见病因之一,但关于高钠血症在脓毒症中作用的研究尚未见诸多报道。在本研究中,我们旨在探究脓毒症患者发生高钠血症的危险因素,并评估合并或未合并高钠血症的脓毒症患者的预后情况。
在这项针对单中心51例脓毒症重症监护病房患者的回顾性队列研究中,我们采用单因素和多因素分析方法,研究了发生高钠血症的危险因素以及高钠血症与临床结局之间的关联。同时,还比较了合并或未合并高钠血症患者的死亡率和住院时长等临床结局。
急性生理与慢性健康状况评分系统II(APACHE II)评分(比值比 = 1.15;95%置信区间:1.022 - 1.294)被发现是脓毒症患者发生高钠血症的唯一独立危险因素。此外,住院期间发生高钠血症的患者显示出明显更高的发病率和死亡率。
急性生理与慢性健康状况评分系统II评分可能是脓毒症患者发生高钠血症的独立危险因素。此外,高钠血症与脓毒症患者更差的预后密切相关。