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重症监护病房脓毒症患者90天死亡率的危险因素分析

Risk factors analysis of 90-day mortality in patients with sepsis in intensive care unit.

作者信息

Xu Yuntian, Zhang He, Li Jiezhi, Wang Nan, Yuan Huifeng

机构信息

Department of Critical Care Medicine, The Third Affiliated Hospital of Anhui Medical University, Hefei First People's Hospital, Hefei, China.

Department of Emergency Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

PLoS One. 2025 Jun 20;20(6):e0325813. doi: 10.1371/journal.pone.0325813. eCollection 2025.

DOI:10.1371/journal.pone.0325813
PMID:40540505
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12180717/
Abstract

BACKGROUND

The incidence and mortality of sepsis in the intensive care unit (ICU) remain persistently high. This study primarily investigates the risk factors associated with the 90-day mortality in sepsis patients.

METHOD

This retrospective study included 123 sepsis patients admitted to a hospital in China from January 2015 to December 2018, clinical and abdominal CT data were compared between survivors and non-survivors, logistic regression and Cox regression analyses were performed on the abdominal CT data, Finally, survival curves for different skeletal muscle indices were analyzed using the Kaplan-Meier (K-M) method.

RESULT

In the abdominal CT scan data, significant differences were observed between survivors and non-survivors in skeletal muscle density (SMD), skeletal muscle area (SMA), skeletal muscle index (SMI), and subcutaneous adipose tissue area (SAT); Cox regression analysis revealed that higher skeletal muscle density (SMD) (HR = 0.953; 95% CI = 0.923-0.984; p = 0.003), skeletal muscle area (SMA) (HR = 0.986; 95% CI = 0.976-0.997; p = 0.011), and skeletal muscle index (SMI) (HR = 0.951; 95% CI = 0.917-0.985; p = 0.005) were significantly associated with lower 90-day mortality compared to non-survivors. Finally, the Kaplan-Meier (K-M) curves demonstrated differences in survival based on the median skeletal muscle index (SMI).

CONCLUSION

Body composition parameters assessed by abdominal CT scans are highly associated with 90-day mortality in ICU patients with sepsis. Among them, SMD, SMA, and SMI are valuable prognostic factors.

摘要

背景

重症监护病房(ICU)中脓毒症的发病率和死亡率一直居高不下。本研究主要调查脓毒症患者90天死亡率的相关危险因素。

方法

这项回顾性研究纳入了2015年1月至2018年12月在中国一家医院收治的123例脓毒症患者,比较了幸存者和非幸存者的临床及腹部CT数据,对腹部CT数据进行了逻辑回归和Cox回归分析,最后使用Kaplan-Meier(K-M)方法分析了不同骨骼肌指数的生存曲线。

结果

在腹部CT扫描数据中,幸存者和非幸存者在骨骼肌密度(SMD)、骨骼肌面积(SMA)、骨骼肌指数(SMI)和皮下脂肪组织面积(SAT)方面存在显著差异;Cox回归分析显示,与非幸存者相比,较高的骨骼肌密度(SMD)(HR = 0.953;95%CI = 0.923 - 0.984;p = 0.003)、骨骼肌面积(SMA)(HR = 0.986;95%CI = 0.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/cf42fe6efc53/pone.0325813.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/c93f5ae3fc7f/pone.0325813.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/4f8b8b31fcc0/pone.0325813.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/cf42fe6efc53/pone.0325813.g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/c93f5ae3fc7f/pone.0325813.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/4f8b8b31fcc0/pone.0325813.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a95/12180717/cf42fe6efc53/pone.0325813.g003.jpg

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Correlation between the Charlson comorbidity index and skeletal muscle mass/physical performance in hospitalized older people potentially suffering from sarcopenia.住院老年疑似肌少症患者的 Charlson 合并症指数与骨骼肌量/身体表现的相关性。
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Focus on sepsis.
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Intensive Care Med. 2019 Oct;45(10):1459-1461. doi: 10.1007/s00134-019-05680-4. Epub 2019 Jul 2.
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The cancer control status and APACHE II score are prognostic factors for critically ill patients with cancer and sepsis.癌症控制状况和急性生理学与慢性健康状况评分系统 II 是癌症合并脓毒症危重症患者的预后因素。
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