内科ICU 中老年脓毒症患者的临床特点及预后危险因素评估
合集下载
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
LIU Yang1, ZHOU Jing-xia2*, LIU Chun-tao2, ZHOU Da-peng2
(1. Chengde Medical College, Chengde Hebei; 2. Chengde Zhongshu Hospital, Chengde Hebei)
ABSTRACT: Objective To investigate the clinical characteristics and prognostic factors of senile sepsis in ICU. Methods Serum albumin (Alb), procalcitonin (Alb), procalcitonin (PCT),) and arterial lactate (LAC), were measured in 49 patients with senile sepsis on admission. Sofa scores, acute physiological and chronic health status Ⅱ (APACHE Ⅱ) scores were recorded. According to the outcome of 28 days, 49 patients with sepsis were divided into survival group (26 cases) and death group (23 cases). Multivariate logistic regression analysis was used to screen the risk factors for predicting death, and the predictive ability of risk factors was compared by using the operating characteristic curve (ROC curve) of the subjects. Results The most common infection sites were lung (44.9%), urinary system (22.4%), abdominal cavity (20.4%) and skin (12.2%). Multivariate logistic regression analysis showed that PCT (OR=1.096, P=0.240) was not a risk factor for predicting death. Age (OR=0.049, P=0.934), APACHE Ⅱ) (OR=0. 802, P = 0.048), lactic acid (OR=0.629, P=0.013), albumin (OR=1.376,P= 0.007), whether or not to undergo blood purification therapy (OR=0.074,) The), SOFA score of 0.04 (OR=0.704) was a risk factor for predicting death. Age, Lac,Alb,APACHE Ⅱ score and area under the SOFA score curve were 0.817~0.845~0.162~0.697~ 0. 874. The SOFA score was the highest and the best judgment level. Conclusion Age, Lac,Alb,APACHE Ⅱ score and SOFA score are risk factors for prognosis of senile sepsis patients, and SOFA score is the most accurate. KEY WORDS: Senile sepsis; Risk factors; Clinical characteristics
本 文 引 用 格 式： 刘 阳 , 周 景 霞 , 刘 春 涛 , 等 . 内 科 ICU 中 老 年 脓 毒 症 患 者 的 临 床 特 点 及 预 后 危 险 因 素 评 估 [J]. 世 界 最 新 医 学 信 息 文 摘 ,2019,19(07):3-4.
Clinical Characteristics and Prognostic Risk Factors of Elderly Patients with Sepsis in Internal Medicine ICU
世界最新医学信息文摘 2019 年第 19 卷第 07 期
3
·论著·
内科 ICU 中老年脓毒症患者的临床特点及预后危险因素评估
刘阳 1，周景霞 2*，刘春涛 2，周大鹏 2
（1. 承德医学院，河北 承德；2. 承德市中心医院，河北 承德）的危险因素。方法 检测 49 例老年脓毒症患者入院时静脉血的白蛋 白（Alb)、降钙素原 (PCT)、和动脉血乳酸 (LAC)，并分别记录 sofa 评分、急性生理和慢性健康状况Ⅱ (APACHE Ⅱ ) 评分。是否行血液净化治疗， 根据 28d 的转归，将 49 例脓毒症患者分为存活组分为存活组（26 例）与死亡组（23 例）比较上述指标在 2 组间有无统计学差异。采用多因素 logistic 回归分析筛选预测死亡的危险因素，应用受试者工作特征曲线 ( Ｒ OC 曲线 ) 比较危险因素的预测能力。结果 最常见的感染部位依次 为肺部（44.9%）、泌尿系（22.4%）、腹腔（20.4%）、皮肤（12.2%），2 组比较，上述指标均有统计学意义。而多因素 logistic 回归分析发 现 PCT(OR=1.096，P=0.240) 不是预测死亡的危险因素；年龄 (OR=0.049，P=0.934)、APACHE Ⅱ评分 (OR=0.802，P=0.048)、乳酸 (OR=0.629， P=0.013)、白蛋白（OR=1.376，P=0.007）是否行血液净化治疗（OR=0.074，P=0.04）、SOFA 评分 (OR=0.704，P=0.027) 是预测死亡的危险因素。 年龄、Lac、Alb、APACHE Ⅱ评分、SOFA 评分曲线下面积分别为：0.817、0.845、0.162、0.697、0.874 可见 SOFA 评分最高 , 为最优秀判断水平。 结论 年龄、Lac、Alb、APACHE Ⅱ评分、SOFA 评分是影响老年脓毒症患者预后的风险因素，SOFA 评分最准确。 关键词：老年脓毒症；危险因素；临床特点 中图分类号：R592 文献标识码：A DOI: 10.19613/ki.1671-3141.2019.07.002
(1. Chengde Medical College, Chengde Hebei; 2. Chengde Zhongshu Hospital, Chengde Hebei)
ABSTRACT: Objective To investigate the clinical characteristics and prognostic factors of senile sepsis in ICU. Methods Serum albumin (Alb), procalcitonin (Alb), procalcitonin (PCT),) and arterial lactate (LAC), were measured in 49 patients with senile sepsis on admission. Sofa scores, acute physiological and chronic health status Ⅱ (APACHE Ⅱ) scores were recorded. According to the outcome of 28 days, 49 patients with sepsis were divided into survival group (26 cases) and death group (23 cases). Multivariate logistic regression analysis was used to screen the risk factors for predicting death, and the predictive ability of risk factors was compared by using the operating characteristic curve (ROC curve) of the subjects. Results The most common infection sites were lung (44.9%), urinary system (22.4%), abdominal cavity (20.4%) and skin (12.2%). Multivariate logistic regression analysis showed that PCT (OR=1.096, P=0.240) was not a risk factor for predicting death. Age (OR=0.049, P=0.934), APACHE Ⅱ) (OR=0. 802, P = 0.048), lactic acid (OR=0.629, P=0.013), albumin (OR=1.376,P= 0.007), whether or not to undergo blood purification therapy (OR=0.074,) The), SOFA score of 0.04 (OR=0.704) was a risk factor for predicting death. Age, Lac,Alb,APACHE Ⅱ score and area under the SOFA score curve were 0.817~0.845~0.162~0.697~ 0. 874. The SOFA score was the highest and the best judgment level. Conclusion Age, Lac,Alb,APACHE Ⅱ score and SOFA score are risk factors for prognosis of senile sepsis patients, and SOFA score is the most accurate. KEY WORDS: Senile sepsis; Risk factors; Clinical characteristics
本 文 引 用 格 式： 刘 阳 , 周 景 霞 , 刘 春 涛 , 等 . 内 科 ICU 中 老 年 脓 毒 症 患 者 的 临 床 特 点 及 预 后 危 险 因 素 评 估 [J]. 世 界 最 新 医 学 信 息 文 摘 ,2019,19(07):3-4.
Clinical Characteristics and Prognostic Risk Factors of Elderly Patients with Sepsis in Internal Medicine ICU
世界最新医学信息文摘 2019 年第 19 卷第 07 期
3
·论著·
内科 ICU 中老年脓毒症患者的临床特点及预后危险因素评估
刘阳 1，周景霞 2*，刘春涛 2，周大鹏 2
（1. 承德医学院，河北 承德；2. 承德市中心医院，河北 承德）的危险因素。方法 检测 49 例老年脓毒症患者入院时静脉血的白蛋 白（Alb)、降钙素原 (PCT)、和动脉血乳酸 (LAC)，并分别记录 sofa 评分、急性生理和慢性健康状况Ⅱ (APACHE Ⅱ ) 评分。是否行血液净化治疗， 根据 28d 的转归，将 49 例脓毒症患者分为存活组分为存活组（26 例）与死亡组（23 例）比较上述指标在 2 组间有无统计学差异。采用多因素 logistic 回归分析筛选预测死亡的危险因素，应用受试者工作特征曲线 ( Ｒ OC 曲线 ) 比较危险因素的预测能力。结果 最常见的感染部位依次 为肺部（44.9%）、泌尿系（22.4%）、腹腔（20.4%）、皮肤（12.2%），2 组比较，上述指标均有统计学意义。而多因素 logistic 回归分析发 现 PCT(OR=1.096，P=0.240) 不是预测死亡的危险因素；年龄 (OR=0.049，P=0.934)、APACHE Ⅱ评分 (OR=0.802，P=0.048)、乳酸 (OR=0.629， P=0.013)、白蛋白（OR=1.376，P=0.007）是否行血液净化治疗（OR=0.074，P=0.04）、SOFA 评分 (OR=0.704，P=0.027) 是预测死亡的危险因素。 年龄、Lac、Alb、APACHE Ⅱ评分、SOFA 评分曲线下面积分别为：0.817、0.845、0.162、0.697、0.874 可见 SOFA 评分最高 , 为最优秀判断水平。 结论 年龄、Lac、Alb、APACHE Ⅱ评分、SOFA 评分是影响老年脓毒症患者预后的风险因素，SOFA 评分最准确。 关键词：老年脓毒症；危险因素；临床特点 中图分类号：R592 文献标识码：A DOI: 10.19613/ki.1671-3141.2019.07.002