急诊ICU真菌感染患者死亡危险因素分析

Analysis of risk factors associated with mortality in patients with fungal infection in emergency ICU

目的:探究急诊ICU(EICU)真菌感染患者的临床特点并分析影响其死亡的危险因素,为临床医师的救治提供参考。方法:回顾性分析2014年1月—2018年12月空军军医大学第一附属医院EICU 162例真菌感染患者的资料,采用单因素及多因素Logistic回归方法,分析影响其死亡的相关危险因素。结果:本院EICU真菌感染患者的病死率为25.9%,APACHEⅡ评分(P=0.000,OR=1.161,95%CI:1.075~1.254)及机械通气(P=0.017,OR=3.108,95%CI:1.224~7.892)是影响其死亡的独立危险因素。结论:对于机械通气或APACHEⅡ评分越高的真菌感染患者,应尽早撤除呼吸机辅助通气并根据APACHEⅡ评分的增高项积极地进行针对性治疗,以降低EICU真菌感染患者的死亡风险。

Objective: To analyze the clinical characteristics and prognostic factors associated with mortality in patients with fungal infection in Emergency Intensive Care Unit(EICU), and provide reference for the treatment. Methods: The clinical data of 162 patients diagnosed with fungal infection in EICU of the First Affiliated Hospital Of Air Force Medical University EICU from January, 2014 to December, 2018 were reviewed. The prognostic factors associated with mortality were analyzed by univariate and multivariate logistic regression analysis. Results: The fatality rate of patients with fungal infection in EICU was 25.9%. APACHE Ⅱ score(P=0.000, OR=1.161, 95%CI: 1.075-1.254) and mechanical ventilation(P=0.017, OR=3.108, 95%CI: 1.224-7.892) were the independent risk factors associated with mortality. Conclusion: For the patients with mechanical ventilation and higher APACHE Ⅱ score, we should remove the ventilator as early as possible and give targeted therapy according to the high items of APACHE Ⅱ score in order to reduce the risk of death.