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对一家三级医院重症监护病房中脓毒症患者和非脓毒症患者的临床及流行病学特征进行评估。

Assessment of clinical and epidemiological characteristics of patients with and without sepsis in intensive care units of a tertiary hospital.

作者信息

Morello Luis Gustavo, Dalla-Costa Líbera Maria, Fontana Rafael Mialski, Netto Ana Cristina Schmidt de Oliveira, Petterle Ricardo Rasmussen, Conte Danieli, Pereira Luciane Aparecida, Krieger Marco Aurélio, Raboni Sonia Mara

机构信息

Instituto Carlos Chagas, Fundação Oswaldo Cruz, Curitiba, PR, Brazil.

Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.

出版信息

Einstein (Sao Paulo). 2019;17(2):eAO4476. doi: 10.31744/einstein_journal/2019AO4476. Epub 2019 Apr 15.

Abstract

OBJECTIVE

To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital.

METHODS

A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records.

RESULTS

We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated.

CONCLUSION

Although the impact of sepsis on mortality is related to patients' clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.

摘要

目的

描述一家公立医院重症监护病房中脓毒症患者及非脓毒症患者的临床和流行病学特征。

方法

于2012年5月至2013年4月开展一项横断面研究。回顾了重症监护病房中脓毒症患者及非脓毒症患者的病历,获取临床和实验室数据。

结果

我们评估了466例患者,其中58%为男性,中位年龄为40岁,146例(31%)被诊断为脓毒症。总体死亡率为20%,脓毒症患者的死亡率显著更高(39%)。与重症监护病房死亡率相关的因素包括脓毒症的存在(比值比:6.1,95%置信区间:3.7 - 10.5)、年龄(比值比:3.6,95%置信区间:1.4 - 7.2)以及住院时间(比值比:0.96,95%置信区间:0.94 - 0.98)。肺部感染(49%)和腹腔内感染(20%)是最常见的感染部位,凝固酶阴性葡萄球菌和肠道革兰氏阴性杆菌是最常见(66%)的分离病原体。

结论

尽管脓毒症对死亡率的影响与患者的临床和流行病学特征相关,但对这些数据进行严格评估很重要,因为这将有助于直接实施针对这一严重公共卫生问题的地方管理政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9750/6459321/be6058f195e0/2317-6385-eins-17-02-eAO4476-gf01.jpg

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