EICU危重症患者预后的影响因素分析

Analysis of influence factors on prognosis outcome of EICU patients

目的:探讨各因素对急诊重症监护病房(EICU)危重症患者预后的影响。方法:回顾性分析165例EICU重症患者的临床资料,根据预后结局将EICU患者分为转出组(n=125)和死亡组(n=40);进行病例对照研究,比较两个组别的APACHE II评分、机械通气时间、血糖水平等指标;多因素分析采用非条件Logistic回归分析。结果:单因素分析结果显示,两个组别的性别、住院类别、体重、APACHEⅡ评分、机械通气时间、平均血糖、血糖标准差、血糖变异系数等指标有差异;多因素分析结果显示,危险因素为手术(OR=3.473)、APACHEII评分(OR=1.092)、机械通气时间(OR=1.005)、低血糖(OR=3.602)、高血糖(OR=2.504)、血糖标准差(OR=1.815)等,而体重(OR=0.938)为保护因素。结论:影响EICU患者死亡的危险因素包括手术、APACHE II评分、机械通气时间、低血糖、应激性高血糖、血糖波动范围。

Objective： To explore the association between different factors and hospital mortality in emergency intensive care unit（EICU）patients.Methods： Retrospectivly collected 165 cases of EICU patients,which divided into survival group（n=125） and death group（n=40） according to prognosis outcome.Adopting case-control study,compared APACHE II score,mechanical ventilation time,blood sugar level indexes between the two groups,and used non-conditional Logistic Regression method to analyze risk factors.Results： One factor analysis result showed that sex,hospitalization type,weight,APACHE II score,mechanical ventilation time,Glu Ave,Glu SD and Glu CV existed significance between the two groups.Multiple factors analysis reslut indicated that operation patients（OR=3.473）,APACHE II score（OR=1.092）,mechanical ventilation time（OR=1.005）,hypoglycemia（OR=3.602）,hyperglycemia（OR=2.504）,Glu SD（OR=1.815） were the risk factors,but weight index（OR=0.938） was the protective factors.Conclusion： The main risk factors of prognosis death of EICU patients were operation patients,APACHE II score,mechanical ventilation time,hypoglycemia,hyperglycemia and Glu SD.