新 Sepsis-3 定义在因严重脓毒症和感染性休克从急诊科收入重症监护病房的患者队列中的应用。

Application of the new Sepsis-3 definition in a cohort of patients with severe sepsis and septic shock admitted to Intensive Care Unit from the Emergency Department.

机构信息

Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Med Clin (Barc). 2019 Jan 4;152(1):13-16. doi: 10.1016/j.medcli.2018.02.012. Epub 2018 Apr 19.

DOI:10.1016/j.medcli.2018.02.012

PMID:29680459

Abstract

BACKGROUND AND OBJECTIVES

After the publication of the new definition for sepsis and septic shock, our objective is to analyse the evolution of patients admitted to ICU with an infection process using the previous and new recommendations.

MATERIALS AND METHODS

This is a sub-analysis of a previous observational prospective study. We included 98 patients admitted to ICU from the emergency department due to infection during an 18-month period. We studied the clinical evolution during ICU admission and hospital mortality.

RESULTS

According to Sepsis-2 definition, 78% percent had septic shock and using Sepsis-3 criteria, 52%; hospital mortality was 29 and 41%, respectively. The RR of hospital mortality of septic shock was 10.3 (95% CI: 2.8-37.5) compared to patients without shock. The 30-day probability survival of patients with sepsis and septic shock were 78% and 68%, respectively (long rank < 0.001).

CONCLUSIONS

In our experience, the incorporation of the SOFA score and lactate levels to the new definition could help improve the evaluation of risk of hospital death.

摘要

背景与目的

新的脓毒症和脓毒性休克定义公布后，我们的目的是分析使用以前和新建议对因感染入住 ICU 的患者的演变情况。

材料和方法

这是一项先前观察性前瞻性研究的子分析。我们纳入了在 18 个月期间因感染而从急诊室转入 ICU 的 98 名患者。我们研究了 ICU 住院期间的临床演变和住院死亡率。

结果

根据 Sepsis-2 定义，78%的患者有脓毒性休克，而根据 Sepsis-3 标准，52%的患者有脓毒性休克；住院死亡率分别为 29%和 41%。与无休克患者相比，脓毒性休克患者的住院死亡率 RR 为 10.3（95%CI：2.8-37.5）。患有败血症和脓毒性休克的患者的 30 天生存率分别为 78%和 68%（长期秩<0.001）。