Shi Xiaopeng, Xu Lijun, Jing Lijuan, Wang Zehua, Zhao Lina, Zhao Xiangmei
Department of Emergency, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
Department of Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Front Microbiol. 2024 Dec 16;15:1509726. doi: 10.3389/fmicb.2024.1509726. eCollection 2024.
Sepsis-associated encephalopathy (SAE) has a high incidence and mortality, especially for elderly patients and patients who are positive for pathogenic microbial infection, this study explored the prognostic factors influencing the prognosis of elderly patients with pathogenic microorganisms positive of sepsis-associated encephalopathy.
Patients with SAE and pathogenic microbiology positive were included in this study from Medical Information Mart for Intensive Care IV (MIMIC IV) database. The main results of this study was analyzed the 28-day mortality rate of patients with pathogenic microorganism positive and SAE by Wilcoxon, Kaplan-Meier curve and other methods.
This study found that older patients with SAE had higher mortality at 28 and 90 days compared with non-older patients with SAE. and infection, the level of APTT and lactate and SAPS III score were independent risk factors for 28-day mortality in elderly patients with SAE, among them, and infection had the best sensitivity (0.893; 0.931) in assessing elderly patients with pathogenic microorganisms positive and SAE; the SAPS III score had the highest AUC (0.681) value and specificity (0.761) in assessing elderly patients with pathogenic microorganisms positive and SAE.
The older patients with SAE had a poor prognosis, the elder patients with pathogenic microorganisms positive and SAE with high levels of APTT and lactate and SAPS III score and and infection should be closely monitored and treated aggressively.
脓毒症相关性脑病(SAE)发病率和死亡率高,尤其在老年患者以及病原微生物感染阳性患者中,本研究探讨影响病原微生物阳性的老年脓毒症相关性脑病患者预后的因素。
从重症监护医学信息数据库IV(MIMIC IV)纳入病原微生物学阳性的SAE患者。本研究主要结果采用Wilcoxon检验、Kaplan-Meier曲线等方法分析病原微生物阳性且患有SAE患者的28天死亡率。
本研究发现,与非老年SAE患者相比,老年SAE患者在28天和90天时死亡率更高。 以及感染、活化部分凝血活酶时间(APTT)和乳酸水平及序贯器官衰竭评估(SOFA)评分是病原微生物阳性的老年SAE患者28天死亡的独立危险因素,其中, 以及感染在评估病原微生物阳性的老年SAE患者时敏感性最佳(分别为0.893;0.931);SOFA评分在评估病原微生物阳性的老年SAE患者时曲线下面积(AUC)值最高(0.681),特异性最强(0.761)。
老年SAE患者预后较差,对于病原微生物阳性、APTT和乳酸水平高、SOFA评分高以及 以及感染的老年SAE患者应密切监测并积极治疗。