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脓毒症的起源与患者短期死亡率的关系:一项使用电子重症监护病房协作研究数据库的回顾性研究

Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database.

作者信息

Li Qinglin, Tong Yingmu, Wang Hai, Ren Jie, Liu Sinan, Liu Tong, Qu Kai, Liu Chang, Zhang Jingyao

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.

Department of SICU, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China.

出版信息

Int J Gen Med. 2021 Dec 24;14:10293-10301. doi: 10.2147/IJGM.S345050. eCollection 2021.

DOI:10.2147/IJGM.S345050
PMID:34992444
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8714464/
Abstract

OBJECTIVE

The aim of this study was to compare the clinical characteristics and short-term mortality of patients with abdominal and pulmonary sepsis.

DESIGN

Retrospective cohort study.

SETTING

Adult intensive care units (ICUs) at tertiary hospitals.

PARTICIPANTS

Adult ICU patients from 2014 to 2015 in the eICU Collaborative Research Database.

INTERVENTIONS

In univariate analysis, we compared the differences in the characteristics of patients in each group. Logistic regression models were used to evaluate the relationships between primary site of sepsis and short-term prognosis.

PRIMARY AND SECONDARY OUTCOME MEASURES

Hospital and ICU survival.

RESULTS

The final dataset included 7023 pulmonary and 2360 abdominal sepsis patients, who accounted for 74.84% and 25.16%, respectively. We compared the results of the baseline characteristics, vital signs and laboratory indicators between the two groups. In the logistic regression models, we found that the hospital and ICU mortality of patients with abdominal sepsis was higher than that with pulmonary sepsis (p < 0.05, OR = 1.15, p < 0.05, OR = 1.19, respectively), although these results were no longer significantly after adjustment for confounders, but in the subgroups with SOFA score ≧ 8, the adjusted hospital mortality rate of patients with abdominal sepsis was 1.30 times higher than that of patients with pulmonary sepsis (p < 0.005, OR = 1.30, 95% CI 1.09-1.55), while there was no significant difference in the subgroups that SOFA score < 8.

CONCLUSION

In the patients with SOFA score ≧ 8, the adjusted hospital mortality of patients with abdominal sepsis was higher than patients with pulmonary sepsis.

摘要

目的

本研究旨在比较腹部脓毒症和肺部脓毒症患者的临床特征及短期死亡率。

设计

回顾性队列研究。

设置

三级医院的成人重症监护病房(ICU)。

参与者

2014年至2015年eICU协作研究数据库中的成人ICU患者。

干预措施

在单变量分析中,我们比较了每组患者特征的差异。采用逻辑回归模型评估脓毒症原发部位与短期预后之间的关系。

主要和次要观察指标

医院和ICU生存率。

结果

最终数据集包括7023例肺部脓毒症患者和2360例腹部脓毒症患者,分别占74.84%和25.16%。我们比较了两组之间的基线特征、生命体征和实验室指标结果。在逻辑回归模型中,我们发现腹部脓毒症患者的医院和ICU死亡率高于肺部脓毒症患者(p < 0. 05,OR = 1.15,p < 0.05,OR = 1.19),尽管在调整混杂因素后这些结果不再显著,但在序贯器官衰竭评估(SOFA)评分≧8的亚组中 ,腹部脓毒症患者调整后的医院死亡率比肺部脓毒症患者高1.30倍(p < 0.005,OR = 1.30,95%置信区间1.09 - 1.55),而在SOFA评分< 8的亚组中没有显著差异。

结论

在SOFA评分≧8的患者中,腹部脓毒症患者调整后的医院死亡率高于肺部脓毒症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6577/8714464/73eaa004a078/IJGM-14-10293-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6577/8714464/73eaa004a078/IJGM-14-10293-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6577/8714464/73eaa004a078/IJGM-14-10293-g0001.jpg

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