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中国湖南省长沙市社区获得性血流感染患者30天死亡率的危险因素

Risk Factors for 30-Day Mortality of Community-Acquired Bloodstream Infection Patients in Changsha City, Hunan Province, China.

作者信息

Li Linqi, Cao Jing, Qin Jiao, Chen Xiangxiang, Yuan Feng, Deng Ping, Xie Hebin

机构信息

School of Public Health, University of South China, Heng Yang, Hunan, People's Republic of China.

The Affiliated Changsha Central Hospital, University of South China, Changsha, Hunan, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Jul 24;17:3209-3218. doi: 10.2147/IDR.S471350. eCollection 2024.

Abstract

PURPOSE

To analyze the factors affecting patients' prognoses based on the community acquired-bloodstream infection patient data from 2017 to 2021.

PATIENTS AND METHODS

The data of 940 patients were retrieved, having at least one positive bilateral blood culture within 48 hours of hospitalization, and grouped into survivor and non-survivor groups. The clinical characteristics, laboratory results, causative pathogen and other indicators were collected and compared, and risk factors were identified by applying Cox proportional hazard regression model to the data.

RESULTS

Community acquired-bloodstream infection is most commonly caused by and . Among the total of 940 selected patients, 52 (5.5%) died during hospitalization. The demographic parameters like age and gender, clinical protocols like maintenance hemodialysis, glucocorticoid use during hospitalization, catheter placement, procaicitonin, total protein, albumin, creatinine, uric acid contents and Sequential Organ Failure Assessment scores were significantly different between the survivor and non-survivor groups. The survival analysis results revealed that age (HR=1.02, 95% CI: 1.00-1.05, =0.002), glucocorticoid use during hospitalization (HR=3.69, 95% CI: 1.62-8.37, =0.021) and Sequential Organ Failure Assessment score (HR=1.10, 95% CI: 1.03-1.18, =0.004) might be the risk factors affecting 30-day mortality in patients with community acquired-bloodstream infection.

CONCLUSION

The identified risk factors may help guide clinical treatment protocol for patients with community acquired-bloodstream infection, providing more effective treatment strategy selection with improved clinical outcomes.

摘要

目的

基于2017年至2021年社区获得性血流感染患者数据,分析影响患者预后的因素。

患者与方法

检索940例患者的数据,这些患者在住院48小时内至少有一次双侧血培养阳性,分为存活组和非存活组。收集并比较临床特征、实验室检查结果、致病病原体及其他指标,应用Cox比例风险回归模型对数据进行分析以确定危险因素。

结果

社区获得性血流感染最常见的致病菌为 和 。在940例入选患者中,52例(5.5%)在住院期间死亡。存活组和非存活组在年龄、性别等人口统计学参数,维持性血液透析、住院期间使用糖皮质激素、置管、降钙素原水平、总蛋白、白蛋白、肌酐、尿酸含量及序贯器官衰竭评估评分等临床指标方面存在显著差异。生存分析结果显示,年龄(HR=1.02,95%CI:1.00-1.05,P=0.002)、住院期间使用糖皮质激素(HR=3.69,95%CI:1.62-8.37,P=0.021)和序贯器官衰竭评估评分(HR=1.10,95%CI:1.03-1.18,P=0.004)可能是影响社区获得性血流感染患者30天死亡率的危险因素。

结论

所确定的危险因素可能有助于指导社区获得性血流感染患者的临床治疗方案,提供更有效的治疗策略选择,改善临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/297c/11283804/f704b0fb3b97/IDR-17-3209-g0001.jpg

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