Department of Emergency, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Acupuncture and Massage College, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Medicine (Baltimore). 2023 Jun 9;102(23):e33881. doi: 10.1097/MD.0000000000033881.
Sepsis has emerged as a major global public health concern due to its elevated mortality and high cost of care. This study aimed to evaluate the risk factors associated with the mortality of sepsis patients in the Intensive Care Unit (ICU), and to intervene in the early stages of sepsis in order to improve patient outcomes and reduce mortality. From January 1st, 2021 to December 31st, 2021, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Huashan Hospital Affiliated to Fudan University, and The Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were designated as sentinel hospitals, and sepsis patients in their respective ICU and Emergency ICU were selected as research subjects, and divided into survivors and non-survivors according to their discharge outcomes. The mortality risk of sepsis patients was subsequently analyzed by logistic regression. A total of 176 patients with sepsis were included, of which 130 (73.9%) were survivors and 46 (26.1%) were non-survivors. Factors identified as having an impact on death among sepsis patients included female [Odds Ratio (OR) = 5.135, 95% confidence interval (CI): 1.709, 15.427, P = .004)], cardiovascular disease (OR = 6.272, 95% CI: 1.828, 21.518, P = .004), cerebrovascular disease (OR = 3.133, 95% CI: 1.093, 8.981, P = .034), pulmonary infections (OR = 6.700, 95% CI: 1.744, 25.748, P = .006), use of vasopressors (OR = 34.085, 95% CI: 10.452, 111.155, P < .001), WBC < 3.5 × 109/L (OR = 9.752, 95% CI: 1.386, 68.620, P = .022), ALT < 7 U/L (OR = 7.672, 95% CI: 1.263, 46.594, P = .027), ALT > 40 U/L (OR = 3.343, 95% CI: 1.097, 10.185, P = .034). Gender, cardiovascular disease, cerebrovascular disease, pulmonary infections, the use of vasopressors, WBC, and ALT are important factors in evaluating the prognostic outcome of sepsis patients in the ICU. This suggests that medical professionals should recognize them expeditiously and implement aggressive treatment tactics to diminish the mortality rate and improve outcomes.
脓毒症已成为一个主要的全球公共卫生关注点,其死亡率高且治疗费用昂贵。本研究旨在评估与重症监护病房(ICU)中脓毒症患者死亡率相关的危险因素,并在脓毒症的早期进行干预,以改善患者预后并降低死亡率。2021 年 1 月 1 日至 2021 年 12 月 31 日,上海中医药大学附属龙华医院、复旦大学附属华山医院和上海中医药大学附属第七人民医院被指定为哨点医院,从各自的 ICU 和急诊 ICU 中选择脓毒症患者作为研究对象,并根据出院结果分为幸存者和非幸存者。随后通过 logistic 回归分析脓毒症患者的死亡风险。共纳入 176 例脓毒症患者,其中 130 例(73.9%)为幸存者,46 例(26.1%)为非幸存者。影响脓毒症患者死亡的因素包括女性[比值比(OR)=5.135,95%置信区间(CI):1.709,15.427,P=.004)]、心血管疾病(OR=6.272,95%CI:1.828,21.518,P=.004))、脑血管疾病(OR=3.133,95%CI:1.093,8.981,P=.034))、肺部感染(OR=6.700,95%CI:1.744,25.748,P=.006))、血管加压素使用(OR=34.085,95%CI:10.452,111.155,P<.001))、白细胞计数(WBC)<3.5×109/L(OR=9.752,95%CI:1.386,68.620,P=.022))、丙氨酸氨基转移酶(ALT)<7 U/L(OR=7.672,95%CI:1.263,46.594,P=.027))、ALT>40 U/L(OR=3.343,95%CI:1.097,10.185,P=.034))。性别、心血管疾病、脑血管疾病、肺部感染、血管加压素的使用、白细胞计数和丙氨酸氨基转移酶是评估 ICU 中脓毒症患者预后的重要因素。这表明医务人员应迅速识别这些因素,并采取积极的治疗策略,以降低死亡率并改善预后。