脓毒症相关性脑病28 d病死的影响因素分析

Risk factors associated with the 28-day mortality of sepsis-associated encephalopathy

目的分析脓毒症相关性脑病(SAE)28 d病死的影响因素。方法选取2015年1月至2019年12月浙江大学医学院附属杭州市第一人民医院收治的127例SAE患者为研究对象,按28 d生存结局分为存活组、病死组。比较两组患者临床资料,并采用多因素logistic回归分析SAE患者28 d病死的影响因素。结果127例SAE患者28 d存活73例(57.5%),病死54例(42.5%)。存活组与病死组在年龄、合并糖尿病比例、降钙素原水平、心功能分级Ⅲ~Ⅳ级比例、序贯器官衰竭(SOFA)评分、急性生理与慢性健康评估(APACHE)Ⅱ评分等方面比较,差异均有统计学意义(均P<0.05);进一步作多因素logistic回归分析显示,SOFA评分(OR=1.198)、APACHEⅡ评分(OR=1.168)是SAE患者28 d病死的独立影响因素(均P<0.05)。结论SOFA评分、APACHEⅡ评分是预测SAE患者28 d病死的独立影响因素。

Objective To explore the risk factors associated with the 28-day mortality of sepsis-associated encephalopathy(SAE).Methods This was a retrospective analysis of all patients with SAE that had been admitted to No.1 Peaple's Hospital of Hangzhou between January 2015 and December 2019.In total,127 patients were divided into death group and survival group based on the 28-day survival outcomes.The baseline clinical characteristics of the two groups were compared,and multivariate Logistic regression analysis was used to investigate the independent risk factors for 28-day mortality in patients with SAE.Results Among 127 SAE patients,54(42.5%)died within 28 days.There were significant differences in age,proportion of underlying diseases such as diabetes mellitus,sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,and procalcitonin level between the survival and death groups(P<0.05).Multivariate analysis revealed that SOFA score(OR=1.198)and APACHEⅡscore(OR=1.168)were independently associated with 28-day mortality in SAE patients(all P<0.05).Conclusion The SOFA score and APACHEⅡscore were independent risk factors for predicting the 28-day mortality of SAE.