脓毒症患者死亡的危险因素分析

目的探讨脓毒症患者预后的相关因素及脓毒症患者死亡的危险因素。方法调查分析152例脓毒症患者临床资料及预后,进行多因素Logistic分析和ROC曲线分析。结果 152例患者死亡率为30.26%,死亡患者脓毒性休克最多,下呼吸道是最主要的原发感染部位,革兰阴性菌感染最多。年龄、APACHEⅡ、急性肾功能衰竭、MODS、合并慢性病、意识障碍、平均动脉压、血肌酐、血糖及电解质紊乱是影响患者死亡的相关因素。脓毒性休克、严重脓毒症、急性肾功能衰竭、MODS、APACHEⅡ、年龄、血肌酐均为患者死亡的独立危险因素。APACHEⅡ、年龄、血肌酐评价预后的ROC曲线下面积分别为0.793、0.689、0.657均有统计学意义(P<0.05)。结论脓毒症死亡率高,随病情严重程度加剧升高,APACHEⅡ、年龄、血肌酐可作为预测患者预后的指标。

Analysis of risk factors for death of patients with sepsis

Objective To investigate the prognosis of patients with sepsis and sepsis patients the risk factors of death. Methods The survey analysis of 152 cases of sepsis with clinical data and prognosis, studied by multivariate Logistic anal ysis and ROC curve analysis. Results The death rate of 152 cases was 30.26%, and most with septic shock, lower respira tory tract infection and gram-negative bacterial infections. Age, APACHE l/, acute renal failure, MODS, the merger of chronic diseases, disturbance of consciousness, mean arterial pressure, serum ereatinine, glucose, and electrolyte imbalance were the relevant factors death. Septic shock, severe sepsis, acute renal failure, MODS, APACHE II, age, serum creatinine were independent risk factors for death. APACHE II, age, serum creatinine evaluation of prognosis of the area under ROC curve were 0.793, 0.689, 0.657, and were statistically significant （P 〈 0.05）. Conclusion Sepsis mortality is high, exacerbat ed by increased with the severity of the disease, APACHE II, age, serum creatinine could be used as indicators to predict patient prognosis.