Lee Sang-Min, Jo You Hwan, Lee Jae Hyuk, Hwang Ji Eun, Park Inwon, Baek Sumin, Jeong Hwain, Um Young Woo, Kim Hee Eun
Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Shock. 2023 Apr 1;59(4):547-552. doi: 10.1097/SHK.0000000000002083. Epub 2023 Jan 19.
Introduction: This study was performed to investigate the predictors of 1-year mortality at discharge in sepsis survivors. Methods: This study was a retrospective analysis of patients with sepsis and septic shock at a single center. Patients who survived hospitalization for sepsis or septic shock between January 2016 and December 2017 were included in this study. Age, sex, body mass index, laboratory results such as blood cell count, C-reactive protein (CRP) and albumin levels, the Sequential Organ Failure Assessment (SOFA) score at the time of discharge and site of infection were compared between the survivors and nonsurvivors at 1 year postdischarge. Multivariate logistic regression was performed to identify the predictors of 1-year mortality. Results: During the study period, 725 sepsis patients were included in the analysis, 64 (8.8%) of whom died within the first year. The nonsurvivors were older and had a lower body mass index and a higher SOFA score at discharge than the survivors ( P < 0.05). Among the laboratory results at discharge, hemoglobin, platelet counts, and albumin concentrations were lower in the nonsurvivors than in the survivors, whereas CRP was higher in the nonsurvivors than in the survivors. In the multivariate logistic regression analysis, serum albumin <2.5 mg/dL and SOFA score ≥2 at discharge were identified as independent prognostic factors for 1-year mortality (odds ratio, 2.616; 95% confidence interval, 1.437-4.751 for albumin <2.5 mg/dL and 2.106, 1.199-3.801 for SOFA score ≥2, respectively). Conclusions: A low serum albumin concentration of <2.5 mg/dL and a high SOFA score of ≥2 at the time of discharge were prognostic factors for 1-year mortality in survivors of sepsis.
本研究旨在调查脓毒症幸存者出院时1年死亡率的预测因素。方法：本研究是对单中心脓毒症和脓毒性休克患者的回顾性分析。纳入了2016年1月至2017年12月因脓毒症或脓毒性休克住院存活的患者。比较了出院后1年时存活者和非存活者的年龄、性别、体重指数、血细胞计数、C反应蛋白（CRP）和白蛋白水平等实验室检查结果、出院时的序贯器官衰竭评估（SOFA）评分以及感染部位。进行多因素逻辑回归以确定1年死亡率的预测因素。结果：在研究期间，725例脓毒症患者纳入分析，其中64例（8.8%）在第一年内死亡。非存活者比存活者年龄更大，出院时体重指数更低且SOFA评分更高（P<0.05）。出院时的实验室检查结果中，非存活者的血红蛋白、血小板计数和白蛋白浓度低于存活者，而CRP高于存活者。在多因素逻辑回归分析中，血清白蛋白<2.5mg/dL和出院时SOFA评分≥2被确定为1年死亡率的独立预后因素（白蛋白<2.5mg/dL的比值比为2.616；95%置信区间为1.437 - 4.751，SOFA评分≥2的比值比为2.106，95%置信区间为1.199 - 3.801）。结论：出院时血清白蛋白浓度<2.5mg/dL和SOFA评分≥2是脓毒症幸存者1年死亡率的预后因素。
