老年脓毒症患者继发PICS的危险因素及预后分析

Risk Factors and Prognosis of Secondary PICS in Elderly Sepsis Patients

目的探讨老年脓毒症患者继发PICS的危险因素及对预后的影响。方法选择肇庆市第二人民医院2019年5月至2020年12月收治的80例老年脓毒症ICU住院患者作为研究对象,对其临床资料进行回顾性分析,根据其有无继发PICS将其分为PICS组和对照组(未发生PICS),通过单因素和多因素Logistic回归分析可能会影响其发生继发PICS的相关因素,同时比较两组患者半年病死率。结果性别、BMI、感染部位、手术治疗、降钙素原、淋巴细胞以及基础疾病和患者继发PICS无明显关系(P>0.05),年龄、ICU时间、机械通气、APACHEⅡ评分以及血清前白蛋白和患者继发PICS存在明显关系(P<0.05)。多因素Logistic回归分析结果显示影响老年脓毒症患者继发PICS的独立危险因素分别为ICU时间、机械通气、APACHEⅡ评分以及血清前白蛋白(P<0.05)。PICS组患者半年病死率明显高于对照组(P<0.05)。结论影响老年脓毒症患者继发PICS的独立危险因素分别为ICU时间、机械通气、APACHEⅡ评分以及血清前白蛋白,继发PICS会对患者预后带来明显影响,容易增加患者病死风险,临床需要根据危险因素及时采取相应的干预措施,以尽量改善患者预后。

Objective To investigate the risk factors of secondary PICS in elderly patients with sepsis and their influence on prognosis.Methods A total of 80 elderly sepsis inpatients with ICU in Zhaoqing Second People’s Hospital from May 2019 to December 2020 were selected as the research subjects,and their clinical data were retrospectively analyzed.According to whether they had secondary PICS,they were divided into PICS group and control group(no PICS).Univariate and multivariate Logistic regression analysis may affect the factors related to the occurrence of secondary PICS.Meanwhile,the half-year mortality rate of the two groups of patients was compared.Results There was no significant correlation between gender,BMI,site of infection,surgical treatment,procalcitonin,lymphocytes and underlying diseases and secondary PICS(P>0.05),but there was significant correlation between age,ICU time,mechanical ventilation,APACHEⅡscore and serum pre-albumin and secondary PICS(P<0.05).Multivariate Logistic regression analysis showed that the independent risk factors for secondary PICS in elderly sepsis patients were ICU time,mechanical ventilation,APACHEⅡscore and serum pre-albumin(P<0.05).The half-year mortality in PICS group was significantly higher than that in control group(P<0.05).Conclusion Effect in elderly patients with sepsis secondary PICS respectively independent risk factors of ICU time,mechanical ventilation,APACHEⅡscore and serum prealbumin,secondary PICS will be obvious influence on the prognosis of patients,easy to increase a patient’s risk of illness,clinical need take appropriate intervention measures in time according to the risk factors to try to improve the prognosis of patients.