入院SIRS评分预测多发伤患者发生院内感染的价值

The Value of Systemic Inflammatory Response Syndrome Score at Admission Predicting Nasocomical Infection in Multiple Trauma Patients

目的:探讨入院SIRS评分预测多发伤患者发生院内感染的价值。方法:本研究共纳入我院急诊创伤中心2003年1月至2004年1月收治的多发伤患者258例,所有患者入院进行了SIRS评分和ISS评分,SIRS定义为SIRS评分≥2。按照有无感染依据将病人分为感染组与非感染组,比较两组间ISS评分、年龄以及SIRS四个变量的差异,统计分析入院SIRS评分与患者发生感染的相关性。结果:感染患者ISS评分、白细胞计数、平均年龄均比非感染者高、而体温则比非感染者低(所有P<0.01)。统计发现,共有88例(34.11%)诊断为SIRS,当作了年龄和ISS变量调整后,低体温和白细胞增多最能预示感染(P<0.01)。通过多元回归分析后发现,入院SIRS评分≥2能预测多发伤患者发生感染的可能性,而且随着SIRS评分增高,发生感染的危险性增加。结论:入院SIRS评分≥2能独立预测多发伤患者发生院内感染的危险性。每日SIRS评分可能有助于早期发现感染从而早期给予干预。

Object：Determine the value of SIRS score at admission predicting nasocomical infection in multiple trauma patients method：Data were collected on 258 multiple trauma patients admitted to our emergency trauma center from January 2003 to January 2004. SIRS score and ISS （Injury Severity Score）score were calculated at admission ,SIRS was defined as SIRS score of≥2. Patients were divided into two groups according to infection or not. We compare the difference of ISS sore, the white blood cell count and four parts of SIRS between the two groups and define the relativity of SIRS at admission and the likelihood of nasocomical infection. Results：The ISS score and the white blood cell count and the mean age of the infected group were higher than the non-infected group, while temperature were lower（P 〈 0.0 1）. 88 （34.11%） patients were diagnosed as SIRS. When adjusted for age and ISS, hypothermia and leukocytosis were the most significant predictors of infection（P 〈 0.01）. SIRS scores of≥2 were increasingly predictive of infection when analyzed by multiple logistic regression analysis. Conclusion：An admission SIRS score of≥ 2 is a significant independent predictor of infection in multiple trauma patients. Daily SIRS scores may be a meaningful method of assessing the risk of infection and initiating earlier intervention.