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住院患者脓毒症预后的预后指标和临床指标:一项横断面研究。

Prognostic and clinical indicators of sepsis outcomes in hospitalized patients: a cross-sectional study.

作者信息

Moazen Javad, Zaniani Fatemeh Riyahi, Kassani Aziz, Akhondshushtari Parisa, Ahmadi Zeynab

机构信息

Infectious and Tropical Diseases Research Center, Dezful University of Medical Sciences, Dezful, Iran.

Department of Community Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.

出版信息

BMC Infect Dis. 2025 Apr 21;25(1):567. doi: 10.1186/s12879-025-10796-8.

Abstract

BACKGROUND

Sepsis is a life-threatening medical emergency that necessitates immediate attention and intervention. Without prompt treatment, it can lead to organ failure, tissue damage, and death. This study aimed to compare potential factors influencing sepsis outcomes between two groups: patients who survived and those who died.

METHODS

In this cross-sectional study, 189 patients admitted to the emergency department of Ganjavian Hospital in Dezful, Southwest Iran, with a primary diagnosis of sepsis between July 2023 and July 2024 were included. Clinical and laboratory data were collected for all patients. Data analysis was performed using SPSS version 16. Patients were categorized into two groups based on outcomes: those discharged and those who died.

RESULTS

The mean age of discharged patients was 63.37 ± 19.77 years, while deceased patients had a mean age of 72.33 ± 14.30 years (p < 0.05). Among patients with urinary tract infections, 23.75% expired. Mortality rates for bacteremia and lung infections were 47.06% and 43.75%, respectively. Only 10.0% of patients with positive DIC survived. Pathogens such as Staphylococcus aureus, Candida albicans, and Acinetobacter baumannii were significantly associated with higher mortality (p < 0.05). Multivariate logistic regression identified cardiovascular disease (CVD) (OR = 1.90, 95% CI: 1.03-3.66, p = 0.04) and chronic lung disease (OR = 4.36, 95% CI: 1.02-18.95, p = 0.03) as significant predictors of mortality. Higher GCS scores and better oxygen saturation (Sato2) were associated with improved survival.

CONCLUSION

Age, level of consciousness, coagulopathy, respiratory rate, and pathogenic microorganisms are critical predictive factors in sepsis outcomes. However, a comprehensive evaluation incorporating multiple clinical and laboratory parameters is essential for accurately assessing and managing sepsis patients.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

脓毒症是一种危及生命的医疗急症,需要立即关注和干预。若不及时治疗,可能导致器官衰竭、组织损伤和死亡。本研究旨在比较影响两组脓毒症患者预后的潜在因素:存活患者和死亡患者。

方法

在这项横断面研究中,纳入了2023年7月至2024年7月期间因初步诊断为脓毒症而入住伊朗西南部迪兹富尔甘贾维安医院急诊科的189例患者。收集了所有患者的临床和实验室数据。使用SPSS 16版进行数据分析。根据预后将患者分为两组:出院患者和死亡患者。

结果

出院患者的平均年龄为63.37±19.77岁,而死亡患者的平均年龄为72.33±14.30岁(p<0.05)。在尿路感染患者中,23.75%死亡。菌血症和肺部感染的死亡率分别为47.06%和43.75%。弥散性血管内凝血(DIC)阳性的患者中只有10.0%存活。金黄色葡萄球菌、白色念珠菌和鲍曼不动杆菌等病原体与较高的死亡率显著相关(p<0.05)。多因素逻辑回归分析确定心血管疾病(CVD)(比值比[OR]=1.90,95%置信区间[CI]:1.03-3.66,p=0.04)和慢性肺病(OR=4.36,95%CI:1.02-18.95,p=0.03)是死亡率的重要预测因素。格拉斯哥昏迷量表(GCS)评分较高和氧饱和度(Sato2)较好与生存率提高相关。

结论

年龄、意识水平、凝血病、呼吸频率和致病微生物是脓毒症预后的关键预测因素。然而,综合评估多个临床和实验室参数对于准确评估和管理脓毒症患者至关重要。

临床试验编号

不适用。

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