摘要
目的探讨急诊科脓毒症患者的危险因素,为改善预后、降低病死率提供科学依据。方法回顾性分析复旦大学附属华山医院静安分院急诊科病房2011年8月-2014年7月140例脓毒症患者情况。采用单因素分析和多因素Logistic回归分析其危险因素。结果将急诊科3年间出院患者信息数据库中所有数据导入Excel 2007,运用Stata7.0统计软件对660例感染病例(140例脓毒症组和520例非脓毒症组)进行描述性分析和危险因素Logistic回归分析。脓毒症发生率为6.8%,病死率为33.6%。多因素Logistic回归分析发现,甲状腺功能异常和D-二聚体升高是急诊科脓毒症患者发病的独立危险因素。对140例脓毒症组中死亡(67例)与存活(73例)进行多因素Logistic回归分析发现,高龄、血脂异常、甲状腺功能异常和肾功能不全是影响脓毒症预后的危险因素。结论急诊科老年患者居多,脓毒症患病率在逐年增高,脓毒症患者多存在甲状腺功能异常和凝血功能障碍。而高龄、高血脂、血肌酐升高和甲状腺功能异常可作为临床独立预判脓毒症患者不良预后的实验依据。
Objective To investigate the predisposing factors of sepsis in the patients in Emergency Department for improving prognosis and decreasing mortality. Methods A total of 140 cases of sepsis were identified from the patients treated in Emergency Department of Huashan Hospital from August 2011 to July 2014. Univariate and multivariate Logistic regression analysis were conducted to characterize the risk factors of sepsis. Results All the data of 660 patients in Emergency Department during the period from August 2011 to July 2014 were processed with Stata 7.0 software for descriptive statistics and logistic regression analysis of risk factors. The patients included 140 cases of sepsis and 520 cases of non-sepsis control. The incidence of sepsis was 6.8% and the case fatality rate of sepsis was 33.6%. Multivariate logistic regression analysis showed that abnormal thyroid function tests and increased serum level of D-dimer were independent risk factors of sepsis in Emergency Department. Multivariate logistic regression analysis for the 67 cases of deaths and 73 cases of survivals in the 140 cases of sepsis indicated that advanced age, dyslipidemia, abnormal thyroid function tests, and abnormal renal function tests were risk factors of death for patients with sepsis. Conclusions Most patients in Emergency Department are old people. The incidence of sepsis is increasing in Emergency Department. Abnormal thyroid function tests and coagulation disorder are common in the patients with sepsis. Advanced age, dyslipidemia, elevated serum creatinine and abnormal thyroid function tests are independent predictors of poor outcome for patients with sepsis in Emergency Department.
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2016年第4期407-410,共4页
Chinese Journal of Infection and Chemotherapy
