急诊重症监护室脓毒性休克患者预后的影响因素分析

Analysis of influencing factors of prognosis of patients with septic shock in emergency intensive care unit

目的:分析急诊重症监护室(EICU)脓毒性休克患者预后的影响因素。方法:选取2020年4月至2022年2月该院EICU收治的203例脓毒性休克患者进行前瞻性研究。收集患者临床资料,采用单因素和多因素Logistic回归分析EICU脓毒性休克患者预后的影响因素。结果:入院28 d内,203例EICU脓毒性休克患者病死79例,病死率为38.92%(79/203);病死者与存活者性别、年龄、EICU住院时间、白细胞计数、血小板计数、血红蛋白水平比较,差异均无统计学意义(P>0.05);病死者红细胞分布宽度(RDW)、动脉血乳酸水平、血清HBP水平、APACHEⅡ评分与存活者比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,RDW、动脉血乳酸水平、血清HBP水平、APACHEⅡ评分升高均为影响EICU脓毒性休克患者预后的独立危险因素(P<0.05)。结论:RDW、动脉血乳酸水平、血清HBP水平、APACHEⅡ评分升高均为影响EICU脓毒性休克患者预后的危险因素,临床应动态监测上述指标,根据结果及时进行针对性干预,以改善临床结局,降低病死率。

Objective:To analyze influencing factors of prognosis of patients with septic shock in emergency intensive care unit(EICU).Methods:A prospective study was conducted on 203 patients with septic shock admitted to the EICU of the hospital from April 2020 to February 2022.The clinical data of these patients were collected.Univariate and multivariate Logistic regression were used to analyze the prognostic factors of influencing factors of prognosis of the patients with septic shock in EICU.Results:Within 28 days of admission,79 of 203 EICU patients with septic shock died with a mortality rate of 38.92%(79/203).There were no statistically significant differences in gender,age,EICU hospitalization time,white blood cell count,platelet count,and hemoglobin level between the deceased and the survivors(P>0.05).There were significant differences in Red blood cell distribution width(RDW),arterial blood lactate levels,serum HBP levels,and acute physiology and chronic health evaluation(APACHE)Ⅱ score between the deceased and the survivors(P<0.05).Multivariate logistic regression analysis showed that RDW,arterial blood lactate level,serum HBP level,and elevated APACHEⅡ score were all risk factors affecting the prognosis of the patients with septic shock in EICU(P<0.05).Conclusions:RDW,arterial blood lactate level,serum HBP level,and elevated APACHEⅡ score are all risk factors affecting the prognosis of the patients with septic shock in EICU.In clinical practice,it is necessary to dynamically monitor the arterial blood lactate,RDW,serum HBP levels,and the APACHEⅡ scores in the patients with septic shock,and targeted interventions based on the results were timely implemented to improve the clinical outcomes and reduce the mortality rate.