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肾功能不全合并血流感染患者预后不良的危险因素分析:一项回顾性研究。

Analysis of risk factors for poor prognosis in patients with renal insufficiency combined with bloodstream infection: a retrospective study.

作者信息

Wang Yunpeng, Zhao Jijing

机构信息

Department of Respiratory Medicine, The First People's Hospital of Jiande, Hangzhou, China.

出版信息

PeerJ. 2025 Aug 29;13:e19993. doi: 10.7717/peerj.19993. eCollection 2025.

Abstract

BACKGROUND

This study analyzed the risk factors for poor prognosis in patients with bloodstream infections and co-occurring renal insufficiency. A nomogram prediction model was constructed to aid in clinical diagnosis and treatment.

METHODS

Data were retrospectively collected from patients admitted to the First People's Hospital of Jiande with positive blood culture results of combined with renal insufficiency. Patients were divided into survival and death groups according to clinical outcome, and independent risk factors for poor prognosis were screened using a multifactorial logistic regression analysis. A nomogram was subsequently established and validated.

RESULTS

The following risk factors and conditions were significantly associated with a higher patient mortality rate: male sex; admission to the ICU; comorbidity with shock, respiratory failure, coma, pneumonia, or leukaemia; the presence of (CRE) organisms; anaemia; thrombocytopenia; elevated D-dimer; hypo-proteinaemia; and hypocalcaemia ( < 0.05). Multifactorial logistic regression analysis suggested that shock, respiratory failure, and CRE bacterial bloodstream infection were independent risk factors for mortality in these patients.

CONCLUSIONS

This study established a nomogram prediction model of risk factors for poor prognosis in patients with renal insufficiency combined with bloodstream infection. This tool can assist clinicians in assessing patient prognosis at an early stage and, therefore, allow for more efficient intervention measures to reduce patient morbidity and mortality.

摘要

背景

本研究分析了血流感染合并肾功能不全患者预后不良的危险因素。构建了列线图预测模型以辅助临床诊断和治疗。

方法

回顾性收集建德市第一人民医院血培养结果阳性且合并肾功能不全患者的数据。根据临床结局将患者分为生存组和死亡组,采用多因素逻辑回归分析筛选预后不良的独立危险因素。随后建立并验证列线图。

结果

以下危险因素和情况与较高的患者死亡率显著相关:男性;入住重症监护病房;合并休克、呼吸衰竭、昏迷、肺炎或白血病;产超广谱β-内酰胺酶(CRE)菌;贫血;血小板减少;D-二聚体升高;低蛋白血症;以及低钙血症(P<0.05)。多因素逻辑回归分析表明,休克、呼吸衰竭和CRE菌血流感染是这些患者死亡的独立危险因素。

结论

本研究建立了肾功能不全合并血流感染患者预后不良危险因素的列线图预测模型。该工具可协助临床医生早期评估患者预后,从而采取更有效的干预措施降低患者发病率和死亡率。

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