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急性肺栓塞合并脓毒症和感染性休克的患病率、危险因素和结局:全国住院患者样本分析。

The prevalence, risk factors, and outcomes of acute pulmonary embolism complicating sepsis and septic shock: a national inpatient sample analysis.

机构信息

Department of Medicine, Mount Sinai Beth Israel, 281 1st Ave, New York, NY, 10003, USA.

Division of Critical Care Medicine, Department of Medicine, The Queen's Medical Center, Honolulu, HI, USA.

出版信息

Sci Rep. 2024 Jul 11;14(1):16049. doi: 10.1038/s41598-024-67105-7.

Abstract

The study aimed to evaluate the prevalence, risk factors, and clinical outcomes of pulmonary embolism in patients diagnosed with sepsis with and without shock. The National Inpatient Sample was used to identify adults with sepsis with and without shock between 2017 and 2019. The prevalence of acute pulmonary embolism and the association of acute pulmonary embolism with in-hospital mortality, hospital length of stay for survivors, and overall costs of hospitalization were evaluated. Multivariable logistic and linear regression analyses, adjusted for various parameters, were used to explore these associations. Of the estimated 5,019,369 sepsis hospitalizations, 1.2% of patients with sepsis without shock and 2.3% of patients with septic shock developed pulmonary embolism. The odds ratio for in-hospital mortality was 1.94 (95% confidence interval (CI) 1.85-2.03, p < 0.001). The coefficient for hospital length of stay was 3.24 (95% CI 3.03-3.45, p < 0.001). The coefficient for total costs was 46,513 (95% CI 43,079-49,947, p < 0.001). The prevalence of pulmonary embolism in patients diagnosed with sepsis with and without shock was 1.2 and 2.3%, respectively. Acute pulmonary embolism was associated with higher in-hospital mortality, longer hospital length of stay for survivors, and higher overall costs of hospitalization.

摘要

这项研究旨在评估诊断为脓毒症且无休克与有休克的患者中肺栓塞的患病率、风险因素和临床结局。利用国家住院患者样本,于 2017 年至 2019 年期间确定了诊断为脓毒症且无休克与有休克的成年人。评估了急性肺栓塞的患病率,以及急性肺栓塞与住院内死亡率、幸存者住院时间的长短和住院总费用之间的关联。使用多变量逻辑和线性回归分析,根据各种参数进行调整,以探讨这些关联。在估计的 5019369 例脓毒症住院患者中,1.2%的无休克脓毒症患者和 2.3%的感染性休克患者发生了肺栓塞。住院内死亡率的优势比为 1.94(95%置信区间(CI)1.85-2.03,p<0.001)。住院时间长短的系数为 3.24(95%CI 3.03-3.45,p<0.001)。总费用的系数为 46513(95%CI 43079-49947,p<0.001)。诊断为脓毒症且无休克与有休克的患者中肺栓塞的患病率分别为 1.2%和 2.3%。急性肺栓塞与较高的住院内死亡率、幸存者住院时间的延长和住院总费用的增加相关。

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