| 孙守松,张鑫雨,陈 静,陈小凤,季娟娟,孙 勇,尹琼玉,王 刚.老年脓毒症和脓毒性休克患者30天死亡率的危险因素分析[J].,2018,(19):3698-3701 |
| 老年脓毒症和脓毒性休克患者30天死亡率的危险因素分析 |
| Analysis of the Risk Factors of 30-day Mortality in Elderly Patients with Sepsis and Septic Shock |
| 投稿时间：2018-03-17 修订日期：2018-04-20 |
| DOI：10.13241/j.cnki.pmb.2018.19.022 |
| 中文关键词: 急诊 老年 脓毒症 30天内死亡率 危险因素 |
| 英文关键词: Emergency Elderly Sepsis Mortality within 30 days Risk factors |
| 基金项目:南京军区科研基金面上课题（12MA043） |
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| 中文摘要: |
| 摘要 目的：探讨就诊于急诊室诊断为脓毒症或者脓毒性休克的患者30天内死亡率与在急诊室初次获得的参数的关系，并探讨死亡率的危险因素。方法：选取2014年6月到2017年6月就诊于我院急诊室且诊断为脓毒血症或者脓毒性休克并有完整随访资料大于65岁的老年患者145例，将30天内存活的患者分为A组，将30天内死亡的患者分为B组，比较两组之间检验指标及生命体征的差异。根据脓毒症序贯器官衰竭评估快速评分(qSOFA)将qSOFA＜2分的定义为a组，qSOFA≥2分的定义为b组，比较两组的死亡率。并采用二项Logistic回归分析探讨30天死亡率的独立危险因素。结果：145例患者中，44.8 %(n=65)的患者在30天内死亡，33.1 %(n=48)的患者需要无创或者侵入性机械通气。A组与B组之间舒张压(P=0.003)、收缩压(P=0.002)、格拉斯哥昏迷量表评分(GCS)(P＜0.001)、血尿素氮(P＜0.001)及qSOFA(P＜0.001)比较均具有统计学差异。a组死亡率(35.7 %)显著低于b组(53.3 %)(P=0.033)。qSOFA是30天内死亡率的独立危险因素(OR=2.871，P=0.004)。结论：qSOFA是老年脓毒症及脓毒性休克患者30天内死亡的的独立危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between 30-day mortality of patients diagnosed with sepsis or septic shock in the emergency room and the initial parameters obtained in the emergency room, and explore the risk factors of mortality. Methods: 145 cases of patients older than 65 years old who were diagnosed as sepsis or septic shock and had complete follow-up data were collected from June 2014 to June 2017 in the emergency room of our hospital were selected. The patients who survived within 30 days were divid- ed into group A, and the patients who died within 30 days were divided into group B. The differences in laboratory inspection parameters and vital signs groups were compared between the two. According to the quick Sepsis-related Organ Failure Assessment (qSOFA), pa- tients with qSOFA<2 points were defined as group a, and patients with qSOFA≥2 points were defined as group b. The mortality was compared between the two groups. Binary logistic regression analysis was used to evaluate independent risk factors for 30-day mortality. Results: Of the 145 cases of patients, 44.8 % (n=65) of patients died within 30 days, and 33.1 % (n=48) of patients required non-invasive or invasive mechanical ventilation. There were statistically significant differences in the diastolic blood pressure (P=0.003), systolic blood pressure (P=0.002), Glasgow Coma Scale (GCS) (P<0.001), blood urea nitrogen (P<0.001), and qSOFA (P<0.001) between group A and group B. The mortality rate of group a (35.7 %) was significantly lower than that of group b (53.3 %)(P=0.033). qSOFA was an indepen- dent risk factor for the mortality within 30 days (OR=2.871, P=0.004). Conclusion: qSOFA is an independent risk factor for the death within 30 days of sepsis and septic shock patients. |
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