Facultad de Medicina, Universidad Cooperativa de Colombia, Antioquia, Colombia.
Departamento de Medicina Interna, Escuela de Medicina, Universidad de Antioquia, Antioquia, Colombia.
Rev Bras Ter Intensiva. 2020 Mar;32(1):28-36. doi: 10.5935/0103-507x.20200006. Epub 2020 May 8.
To explore the association between demographic and clinical factors and the presentation of septic shock in patients treated by prehospital emergency services in five Colombian cities between 2015 and 2016.
This was a cross-sectional study with retrospective data collection. Clinical and demographic data were collected from the medical records of patients diagnosed with sepsis who received prehospital care in five Colombian cities in 2015 and 2016. The diagnosis of septic shock was checked in 20% of the cases, generating two analyzed scenarios: observed and verified. Data were analyzed using the chi-square test, Student's t test and an adjusted logistic regression model. Covariates with p < 0.05 were considered significant.
There was a higher frequency of septic shock in women (62.6%) and in individuals older than 80 years (64.5%), but these were not differentiating factors for septic shock. The most common source of infection was the urinary tract. In the observed scenario, age over 60 (prevalence ratio (PR): 3.22; 95% confidence interval (CI): 1.45 - 35.01) and history of cancer (PR: 1.20; 95%CI: 1.2 - 12.87) were the characteristics associated with septic shock, whereas in the verified scenario, chronic obstructive pulmonary disease (PR: 1.99; 95%CI: 1.26 - 7.14), history of cancer (PR: 1.15; 95%CI: 1.11 - 6.62) and presence of hypovolemia (PR: 1.41; 95%CI: 1.02 - 5.50) were observed.
The most important risk factors for septic shock in prehospital care patients in five Colombian cities were oncological and pulmonary diseases and hypovolemia.
探讨 2015 年至 2016 年期间，5 个哥伦比亚城市的院前急救服务治疗的患者中，人口统计学和临床因素与脓毒症休克表现之间的关系。
这是一项回顾性数据收集的横断面研究。从 2015 年和 2016 年 5 个哥伦比亚城市接受院前护理的被诊断为脓毒症的患者的病历中收集临床和人口统计学数据。在 20%的病例中检查了脓毒性休克的诊断，产生了两个分析场景：观察和验证。使用卡方检验、学生 t 检验和调整后的逻辑回归模型对数据进行分析。具有 p<0.05 的协变量被认为具有统计学意义。
女性（62.6%）和 80 岁以上（64.5%）患者中脓毒性休克的频率更高，但这些因素并不是脓毒性休克的区分因素。最常见的感染源是泌尿道。在观察场景中，年龄大于 60 岁（患病率比（PR）：3.22；95%置信区间（CI）：1.45-35.01）和癌症史（PR：1.20；95%CI：1.2-12.87）是与脓毒性休克相关的特征，而在验证场景中，慢性阻塞性肺疾病（PR：1.99；95%CI：1.26-7.14）、癌症史（PR：1.15；95%CI：1.11-6.62）和存在低血容量（PR：1.41；95%CI：1.02-5.50）观察到。
5 个哥伦比亚城市的院前急救服务患者中脓毒性休克最重要的危险因素是肿瘤和肺部疾病以及低血容量。
