Ramasco F, Figuerola A, Mendez R, Rodríguez Serrano D, von Wernitz A, Hernández-Aceituno A, Sáez C, Cardeñoso L, Martin E, García-Vázquez N, de Las Cuevas C, Pascual N, Bautista A, Jiménez D, Fernández G, Leal A, Vinuesa M, Pizarro A, di Martino M, Del Campo L, García Sanz I, Chicot M, Barrios A, Rubio M J
Fernando Ramasco, Anesthesiology and Surgical Critical Care Departament, University Hospital of La Princesa, C/ Diego de León 62, Madrid, 28006, Spain.
Rev Esp Quimioter. 2019 Jun;32(3):238-245. Epub 2019 Apr 9.
To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors.
A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses.
A total of 237 patients were included. The in-hospital mortality was 24% at 30 days and 27% at 60 days. The mortality of patients admitted to Critical Care Units was 30%. Significant differences were found between the patients who died and those who survived in mean levels of creatinine (2.30 vs 1.46 mg/dL, p <0.05), lactic acid (6.10 vs 2.62 mmol/L, p <0.05) and procalcitonin (23.27 vs 12.73 mg/dL, p<0.05). A statistically significant linear trend was found between SOFA scale rating and mortality (p<0.05). In the multivariate analysis additional independent risk factors associated with death were identified: age > 65 years (OR 5.33, p <0.05), lactic acid > 3 mmol/L (OR 5,85, p <0,05), creatinine > 1,2 mgr /dL (OR 4,54, p <0,05) and shock (OR 6,57, P <0,05).
The epidemiological, clinical and mortality characteristics of the patients in our series are similar to the best published in the literature. The study has identified several markers that could be useful at a local level to estimate risk of death in septic patients. Studies like this one are necessary to make improvements in the Code Sepsis programs.
评估在一家高复杂性医院应用脓毒症规范头几个月的影响，分析患者的流行病学和临床特征以及预后因素。
在连续七个月（2015年2月至2015年9月）期间进行了一项长期观察性研究。使用单变量和多变量分析来分析危险因素、分析值与死亡率之间的关系。
共纳入237例患者。30天内住院死亡率为24%，60天内为27%。重症监护病房收治患者的死亡率为30%。死亡患者和存活患者在肌酐平均水平（2.30 vs 1.46mg/dL，p<0.05）、乳酸（6.10 vs 2.62mmol/L，p<0.05）和降钙素原（23.27 vs 12.73mg/dL，p<0.05）方面存在显著差异。在序贯器官衰竭评估（SOFA）量表评分与死亡率之间发现了具有统计学意义的线性趋势（p<0.05）。在多变量分析中，确定了与死亡相关的其他独立危险因素：年龄>65岁（比值比[OR]5.33，p<0.05）、乳酸>3mmol/L（OR 5.85，p<0.05）、肌酐>1.2mg/dL（OR 4.54，p<0.05）和休克（OR 6.57，p<0.05）。
我们系列中患者的流行病学、临床和死亡率特征与文献中发表的最佳数据相似。该研究确定了几个在当地层面可用于估计脓毒症患者死亡风险的标志物。这样的研究对于改进脓毒症规范项目是必要的。
