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收治于西班牙三家重症监护病房的中毒患者:中毒类型、死亡率以及常用预后评分的功能。

Patients Admitted to Three Spanish Intensive Care Units for Poisoning: Type of Poisoning, Mortality, and Functioning of Prognostic Scores Commonly Used.

机构信息

Intensive Care Unit, Regional University Hospital, Málaga, Spain.

Intensive Care Unit, Infanta Margarita Hospital, Cabra, Córdoba, Spain.

出版信息

Biomed Res Int. 2017;2017:5261264. doi: 10.1155/2017/5261264. Epub 2017 Mar 28.

Abstract

. To evaluate the gravity and mortality of those patients admitted to the intensive care unit for poisoning. Also, the applicability and predicted capacity of prognostic scales most frequently used in ICU must be evaluated. . Multicentre study between 2008 and 2013 on all patients admitted for poisoning. . The results are from 119 patients. The causes of poisoning were medication, 92 patients (77.3%), caustics, 11 (9.2%), and alcohol, 20 (16,8%). 78.3% attempted suicides. Mean age was 44.42 ± 13.85 years. 72.5% had a Glasgow Coma Scale (GCS) ≤8 points. The ICU mortality was 5.9% and the hospital mortality was 6.7%. The mortality from caustic poisoning was 54.5%, and it was 1.9% for noncaustic poisoning ( < 0.001). After adjusting for SAPS-3 (OR: 1.19 (1.02-1.39)) the mortality of patients who had ingested caustics was far higher than the rest (OR: 560.34 (11.64-26973.83)). There was considerable discrepancy between mortality predicted by SAPS-3 (26.8%) and observed (6.7%) (Hosmer-Lemeshow test: = 35.10; < 0.001). The APACHE-II (7,57%) and APACHE-III (8,15%) were no discrepancies. . Admission to ICU for poisoning is rare in our country. Medication is the most frequent cause, but mortality of caustic poisoning is higher. APACHE-II and APACHE-III provide adequate predictions about mortality, while SAPS-3 tends to overestimate.

摘要

. 评估因中毒而入住重症监护病房的患者的严重程度和死亡率。此外,还必须评估重症监护病房中最常使用的预后评分量表的适用性和预测能力。. 2008 年至 2013 年期间对所有因中毒而住院的患者进行的多中心研究。. 研究结果来自 119 名患者。中毒的原因是药物,92 名患者(77.3%),腐蚀性物质,11 名患者(9.2%),酒精,20 名患者(16.8%)。78.3%的患者企图自杀。平均年龄为 44.42 ± 13.85 岁。72.5%的格拉斯哥昏迷量表(GCS)≤8 分。重症监护病房死亡率为 5.9%,医院死亡率为 6.7%。腐蚀性中毒的死亡率为 54.5%,非腐蚀性中毒的死亡率为 1.9%(<0.001)。调整 SAPS-3 后(OR:1.19(1.02-1.39)),摄入腐蚀性物质的患者死亡率远高于其他患者(OR:560.34(11.64-26973.83))。SAPS-3 预测的死亡率(26.8%)与观察到的死亡率(6.7%)之间存在较大差异(Hosmer-Lemeshow 检验:=35.10;<0.001)。APACHE-II(7.57%)和 APACHE-III(8.15%)无差异。. 我国因中毒而入住重症监护病房的情况较为少见。药物是最常见的原因,但腐蚀性中毒的死亡率更高。APACHE-II 和 APACHE-III 对死亡率的预测较为准确,而 SAPS-3 则往往偏高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221e/5387818/601abd2b240f/BMRI2017-5261264.001.jpg

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