Division of Education and Research, Hospital de Especialidades Eugenio Espejo,Universidad Central del Ecuador, Quito, Ecuador,Division of Pediatric Critical Care, Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil,Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Medicine (Baltimore). 2022 Mar 18;101(11). doi: 10.1097/MD.0000000000029096.
To investigate risk factors for mortality from sepsis in an intensive care unit (ICU) in Quito-Ecuador and their association to adherence to Surviving Sepsis Campaign recommendations.Prospective cohort study of patients with severe sepsis/septic shock admitted to the ICU of a public Ecuadorian hospital from March, 2018 to March, 2019. Demographic, clinical, treatment, and outcome data were collected from patients' health records. Patients were divided into 2 groups according to ICU survival or death. Log-binomial regression models were used to identify risk factors for mortality.In total, 154 patients were included. Patients who died in the ICU (n = 42; 27.3%) had higher sequential organ failure assessment score (median 11.5 vs 9; P<.01), more organ dysfunction (median 4 vs 3; P<.0001), and received greater volumes of fluid resuscitation in the first 6 hours (median 800 vs 600 mL; P = .01). Dysfunction of > 2 organs was a risk factor for mortality (relative risks [RR] 3.80, 95% CI 1.33-10.86), while successful early resuscitation (RR 0.32, 95% CI 0.15-0.70), successful empirical antibiotic treatment (RR 0.38, 95%CI 0.18-0.82), and antibiotic de-escalation (RR 0.28, 95%CI 0.13-0.61) were protective factors.Dysfunction of >2 organs was a risk factor for mortality from sepsis while successful early resuscitation and appropriate antibiotic treatment were protective.
在厄瓜多尔基多的一家 ICU 中调查导致败血症患者死亡的风险因素，并研究这些因素与是否遵循《拯救脓毒症运动》建议之间的相关性。
这是一项前瞻性队列研究，纳入了 2018 年 3 月至 2019 年 3 月期间入住厄瓜多尔一家公立医院 ICU 的严重败血症/败血症性休克患者。从患者的病历中收集了人口统计学、临床、治疗和结局数据。根据 ICU 存活或死亡情况将患者分为 2 组。采用对数二项式回归模型来确定死亡的风险因素。
共纳入了 154 名患者。在 ICU 中死亡的患者（n=42；27.3%）的序贯器官衰竭评估评分更高（中位数 11.5 分比 9 分；P<.01），器官功能障碍更多（中位数 4 个器官比 3 个器官；P<.0001），且在最初 6 小时内接受的液体复苏量更大（中位数 800 毫升比 600 毫升；P=.01）。存在>2 个器官功能障碍是死亡的风险因素（相对风险 [RR] 3.80，95%CI 1.33-10.86），而早期复苏成功（RR 0.32，95%CI 0.15-0.70）、经验性抗生素治疗成功（RR 0.38，95%CI 0.18-0.82）和抗生素降阶梯治疗（RR 0.28，95%CI 0.13-0.61）是保护性因素。
存在>2 个器官功能障碍是败血症患者死亡的风险因素，而早期复苏成功和适当的抗生素治疗是保护性因素。
