脓毒症合并活动性结核危重患者的死亡危险因素分析

Risk Factors for Mortality among Patients with Sepsis Complicated with Active Tuberculosis

目的探讨脓毒症合并活动性结核危重患者死亡的危险因素。方法对四川大学华西医院重症医学科符合入选标准的61例患者进行回顾性分析,将患者按照出院结局,分为死亡组19例,存活组42例,筛选出可能与预后相关的因素,进行logistic回归分析。结果急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、结核菌痰涂片阳性、结核延迟治疗和急性肾损伤可作为患者死亡的独立危险因素。结论脓毒症合并活动性结核危重患者死亡率高。APACHEⅡ评分、结核菌痰涂片阳性、结核延迟治疗和急性肾损伤是影响这类患者预后的重要因素。

Objective To determine risk factors associated with mortality of patients with sepsis complicated with active tuberculosis（TB）in intensive care units（ICU）.Methods We reviewed medical records of 61 TB patients whom were admitted to the ICU in West China Hospital of Sichuan University,among whom 19 were dead.Logistic regression models were established to determine predictors of mortality.Results The acute physiology and chronic health evaluation（APACHE Ⅱ）score,smear-positive sputum,delayed treatment of active TB and acute kidney dysfunction were independent predictors of mortality.Conclusion Mortality of patients with sepsis complicated with active tuberculosis is high.APACHE Ⅱscore,smear-positive sputum,delayed treatment of active TB and acute kidney dysfunction are independent predictors of mortality.