危重症患者ICU后综合征的危险因素分析

Analysis on risk factors of post-ICU syndrome in critically ill patients

目的调查危重症患者发生ICU后综合征的危险因素。方法收集镇江市某三级甲等医院2016年2月至2017年1月入住ICU治疗的危重症患者,采集相关临床资料,如基本资料、临床治疗、护理记录及实验室检查。采用意识模糊评估法、住院焦虑抑郁量表和Barthel Index评分进行测评,通过Logistic回归进行多因素分析。结果共纳入218例符合条件的患者,54例(24.8%)发生ICU后综合征。Logistic回归结果显示饮酒史(OR=20.867,95%CI 1.997~218.007,P<0.05)、急性生理及慢性健康状况(APACHE)Ⅱ评分(OR=1.604,95%CI 1.215~2.118,P<0.01)、血氧饱和度(OR=0.632,95%CI 0.435~0.918,P<0.05)与C-反应蛋白(OR=1.073,95%CI 1.033~1.114,P<0.01)与危重患者ICU后综合征的发生独立相关。结论危重症患者ICU后综合征的发生率较高,既往有饮酒史、APACHEⅡ评分高、低血氧饱和度和C-反应蛋白水平高是ICU后综合征的独立危险因素。

Objective To investigate the risk factors of post-intensive care unit(ICU)syndrome occurrence in critically ill patients.Methods Critically ill patients in ICU of a class 3A hospital of Zhenjiang City from February 2016 to January 2017 and their related clinical data such as general data,clinical treatment,nursing record and laboratory detection were collected.The confusion assessment method,Hospitalization Anxiety and Depression Scale and Barthel Index were adopted to conduct the assessment.The multivariate analysis was performed by using Logistic regression.Results A total of 218 cases conforming to the condition were included,54 cases(24.8%)developed post-ICU syndrome.The Logistic regression analysis results showed that the drinking history(OR=20.867,95%CI 1.997-218.007,P<0.05),APACHEⅡscore(OR=1.604,95%CI 1.215-2.118,P<0.01),blood oxygen saturation(OR=0.632,95%CI 0.435-0.918,P<0.05)and C-reactive protein(OR=1.073,95%CI 1.033-1.114,P<0.01)had the independent correlation with post-ICU syndrome occurrence in critically ill patients.Conclusion The incidence rate of post-ICU syndrome in critically ill patients is in high level,and the previous drinking history,high APACHEⅡscore,low level of blood oxygen saturation and high level of C-reactive protein are the independent risk factors for post-ICU syndrome.