Borah Pollov, Saloi Dilip K, Deka Amarendra, Hazarika Rajib, Konwar Ranjumoni, Mahanta Putul, Kalita Deepjyoti, Phukan Chiranjita, Das Kahua
Anaesthesiology, Jorhat Medical College and Hospital, Jorhat, IND.
Anaesthesiology, Assam Medical College and Hospital, Dibrugarh, IND.
Cureus. 2021 Mar 16;13(3):e13915. doi: 10.7759/cureus.13915.
Objectives The clinical factors affecting a patient's condition monitored over time could be useful not only to decide on an intervention that may increase the patients' possibilities of survival but also to predict the treatment outcome. Therefore, this study evaluates the clinical factors as predictors of mortality among severe sepsis patients admitted in the intensive care unit (ICU) of a tertiary care center. Method We did a prospective study on over 50 life-threatening infective cases with different causes admitted in the ICU. Clinical and biochemical parameters like temperature, heart rate, blood pressure, bicarbonate levels, blood lactate levels, and pH were monitored at admission, after 24 hours, and after 72 hours. The statistical analysis was done using Microsoft Excel (Microsoft Corporation, Redmond, WA) and the Statistical Package for the Social Studies (SPSS) version 22 (IBM Corp., Armonk, NY). We have obtained ethical clearance from the ethics committee (human) of Assam Medical College and Hospital, Dibrugarh. Before the collection of the data, we also took informed consent from the participants. Results The mean age of non-survivors was 44.35±11.64 years and that of survivors was 36.60±9.28 years, and the difference was statistically significant (p-value <0.003). An analysis of values of the various vital signs indicated substantial differences in the mean at different time intervals among survivors and non-survivors (p-value <0.05). Among non-survivors, mean temperature, pulse, and rate of respiration were observed to increase over time while blood pressure and oxygen saturation levels were significantly decreasing. Compared to survivors, the mean lactate levels of non-survivors at different time intervals were statistically significant (p-value <0.05). It is also observed that the pH of non-survivors was lower than survivors, and the mean pH value significantly different at different time intervals among the two groups (p-value <0.05). Conclusion The temperature, pulse, rate of respiration, blood pressure, and oxygen saturation levels are essential determinants of patient mortality in those suffering from a severe infection, besides serial lactate levels, bi-carbonate levels, and pH levels.
目的 随着时间推移，影响患者病情的临床因素不仅有助于决定采取可能提高患者生存几率的干预措施，还能预测治疗结果。因此，本研究评估了在一家三级医疗中心重症监护病房（ICU）收治的严重脓毒症患者中，作为死亡率预测指标的临床因素。方法 我们对ICU收治的50多例不同病因的危及生命的感染病例进行了前瞻性研究。在入院时、24小时后和72小时后监测临床和生化参数，如体温、心率、血压、碳酸氢盐水平、血乳酸水平和pH值。使用Microsoft Excel（微软公司，华盛顿州雷德蒙德）和社会科学统计软件包（SPSS）版本22（IBM公司，纽约州阿蒙克）进行统计分析。我们已获得迪布鲁格尔阿萨姆医学院和医院伦理委员会（人类）的伦理批准。在收集数据之前，我们还获得了参与者的知情同意。结果 非幸存者的平均年龄为44.35±11.64岁，幸存者的平均年龄为36.60±9.28岁，差异具有统计学意义（p值<0.003）。对各种生命体征值的分析表明，幸存者和非幸存者在不同时间间隔的平均值存在显著差异（p值<0.05）。在非幸存者中，观察到平均体温、脉搏和呼吸频率随时间增加，而血压和血氧饱和度水平显著下降。与幸存者相比，非幸存者在不同时间间隔的平均乳酸水平具有统计学意义（p值<０.05）。还观察到非幸存者的pH值低于幸存者，两组在不同时间间隔的平均pH值有显著差异（p值<0.05）。结论 除了连续的乳酸水平、碳酸氢盐水平和pH值外，体温、脉搏、呼吸频率、血压和血氧饱和度水平是严重感染患者死亡率的重要决定因素。
