基于多元Logistics回归模型分析重症监护室重症患者获得性衰弱的危险因素

Risk Factors of Acquired Asthenia in ICU Patients Based on Multiple Logistics Regression Model

目的:探讨重症监护室重症患者获得性衰弱的危险因素。方法:纳入我院2021年1月—2022年12月在我院ICU入住的重症患者200例,根据衰弱评分(MRC)评估结果分为获得性衰弱组和无获得性衰弱组,对比分析两组患者的病人特征、临床特征、实验室检查、治疗方法,从而分析得出重症监护室重症患者获得性衰弱的危险因素。结果:获得性衰弱组在具有年龄、女性比例、APACHEⅣ评分、SOFA评分、电解质紊乱比例、营养不良比例、高血糖比例、血小板计数、乳酸水平、糖皮质激素的治疗比例、机械通气比例、血管活性药物的使用比例、氨基糖苷类药物治疗比例均明显高于无获得性衰弱组(P<0.05),获得性衰弱组pH值、血钙值低于无获得性衰弱组(P<0.05),Logistics多元回归模型中得到:年龄、性别、APACHEⅣ评分、SOFA评分、电解质紊乱、营养不良、高血糖、乳酸、低血钙、糖皮质激素的治疗、机械通气、血管活性药物的使用、用氨基糖苷类药物治疗为ICU-AW的独立危险因素。结论:重症监护室重症患者获得性衰弱与临床很多因素相关,为了预防ICU-AW的发生,应当注意具有以上危险因素的患者。

Objective:To investigate the risk factors of acquired asthenia in ICU patients.Methods:A total of 200 severe patients admitted to ICU of our hospital from January 2021 to December 2022 were included and divided into acquired asthenia group and non-acquired asthenia group according to the assessment results of Medical Research Council(MRC).The patient characteristics,clinical characteristics,laboratory examination and treatment methods of the two groups were compared and analyzed,so as to analyze the risk factors of acquired asthenia in ICU patients.Results:The acquired asthenia group had age,female ratio,APACHEⅣscore,SOFA score,proportion of electrolyte disturbance,proportion of malnutrition,proportion of hyperglycemia,platelet count,lactate level,proportion of glucocorticoid treatment,proportion of mechanical ventilation,proportion of vasoactive drug use,proportion of aminoglycoside drug treatment were significantly higher than those in non-acquired asthenia group(P<0.05).pH value,blood calcium value of acquired asthenia group is lower than that of non-acquired asthenia group(P<0.05).Logistics multiple regression model can obtain:age,sex,APACHEⅣscore,SOFA score,electrolyte disturbance,malnutrition,hyperglycemia,lactic acid,hypocalcialemia,glucocorticoid therapy,mechanical ventilation,use of vasoactive drugs,independent risk factors for ICU-AW treatment with aminoglycosides.Conclusion:Acquired asthenia in ICU patients is associated with many clinical factors.In order to prevent the occurrence of ICU-AW,attention should be paid to patients with the above risk factors.