Maluangnon C, Joyjumroon B, Phawanawichian C, Tongyoo S
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
South Afr J Crit Care. 2025 May 19;41(1):e2453. doi: 10.7196/SAJCC.2025.v41i1.2453. eCollection 2025.
Shock, characterised by circulatory hypoperfusion and cellular hypoxia, represents a critical medical condition requiring immediate attention. Despite its significance, there are limited data on shock incidence and outcomes, particularly within the context of Thailand.
This retrospective observational study aimed to investigate the incidence, management and outcomes of shock patients admitted to the internal medicine department of Siriraj Hospital, a referral university hospital in Bangkok, Thailand. Additionally, the study sought to identify factors associated with mortality among these patients.
Medical records of patients admitted were reviewed. Shock cases were identified based on specific diagnostic criteria, and demographic and clinical data were extracted for analysis.
A total of 125 patients were included in the study, with septic shock being the most prevalent condition (40.0%), followed by cardiogenic shock (39.2%), hypovolaemic shock (18.4%) and obstructive shock (2.4%). The overall intensive care unit (ICU) admission rate was 46.7%, varying among shock types, with cardiogenic shock patients exhibiting the highest rate. The overall 28-day mortality rate was 23.7%, with septic shock patients admitted to the ICU demonstrating the highest mortality rate (50.0%). The multivariate analysis identified factors associated with mortality, including colloid resuscitation (adjusted odds ratio (aOR) 3.10 (1.08 - 8.9), p=0.036); vasopressor dose of more than 0.2 µg/kg/min (aOR 4.38 (1.39 - 13.74), p=0.011); and renal replacement therapy (aOR 3.43 (1.04 - 11.28), p=0.043).
This study provides significant insights into shock incidence, management and outcomes in a tertiary referral hospital in Thailand. It also highlights challenges related to ICU bed availability and identifies predictors of mortality. Early recognition and tailored interventions are crucial for improving outcomes in shock patients.
This study provides the comprehensive evaluation of shock incidence, management and outcomes among internal medicine patients. By identifying critical care resource limitations and key predictors of mortality, the findings offer valuable insights for improving early recognition and tailored interventions in resource-constrained settings.
休克以循环灌注不足和细胞缺氧为特征，是一种需要立即关注的危急病症。尽管其意义重大，但关于休克发病率和结局的数据有限，尤其是在泰国的背景下。
这项回顾性观察性研究旨在调查泰国曼谷一所转诊大学医院——诗里拉吉医院内科收治的休克患者的发病率、治疗情况和结局。此外，该研究还试图确定这些患者中与死亡率相关的因素。
对收治患者的病历进行回顾。根据特定诊断标准确定休克病例，并提取人口统计学和临床数据进行分析。
该研究共纳入125例患者，其中感染性休克最为常见（40.0%），其次是心源性休克（39.2%）、低血容量性休克（18.4%）和梗阻性休克（2.4%）。重症监护病房（ICU）的总体收治率为46.7%，因休克类型而异，心源性休克患者的收治率最高。总体28天死亡率为23.7%，入住ICU的感染性休克患者死亡率最高（50.0%）。多因素分析确定了与死亡率相关的因素, 包括胶体复苏（校正比值比（aOR）3.10（1.08 - 8.9），p = 0.036）；血管活性药物剂量超过0.2 μg/kg/min（aOR 4.38（1.39 - 13.74），p = 0.011）；以及肾脏替代治疗（aOR 3.43（1.04 - 11.28），p = 0.043）。
本研究为泰国一家三级转诊医院的休克发病率、治疗情况和结局提供了重要见解。它还突出了与ICU床位可用性相关的挑战，并确定了死亡率的预测因素。早期识别和针对性干预对于改善休克患者的结局至关重要。
本研究对内科患者的休克发病率、治疗情况和结局进行了全面评估。通过确定重症监护资源限制和死亡率的关键预测因素，研究结果为在资源有限的环境中改善早期识别和针对性干预提供了有价值的见解。
