影响重症加强护理病房老年脓毒症合并急性肾损伤患者预后的高危因素

High Risk Factors Affecting Prognosis of Elderly Patients with Sepsis complicated with Acute Kidney Injury in Intensive Care Unit

目的探讨影响重症加强护理病房(ICU)老年脓毒症合并急性肾损伤患者预后的高危因素。方法选取2020年2月至2022年3月宜兴市中医医院收治的ICU老年脓毒症合并急性肾损伤患者128例作为研究对象,按照28d后生存情况分为生存组(n=94)及死亡组(n=34),采用单因素及多因素Logistic回归分析探讨影响ICU老年脓毒症合并急性肾损伤患者预后的高危因素。结果死亡组与生存组性别、感染类型、吸烟饮酒、是否需要机械通气治疗、脓毒症分级、血管活性药物使用情况、序贯器官衰竭(SOFA)评分比较,差异无统计学意义(P>0.05)。死亡组与生存组相比年龄、急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分较高,急性肾损伤分级较高,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、APACHEⅡ评分、急性肾损伤分级可作为影响ICU老年脓毒症合并急性肾损伤患者预后的高危因素。结论年龄、APACHEⅡ评分、急性肾损伤分级可作为影响ICU老年脓毒症合并急性肾损伤患者预后的高危因素。

ObjectiveTo explore the high risk factors affecting the prognosis of elderly patients with sepsis complicated with acute kidney injury in intensive care unit(ICU).Methods A total of 128 elderly patients with sepsis combined with acute kidney injury in ICU admitted to Yixing Hospital of Traditional Chinese Medicine from February 2020 to March 2022 were selected as the study subjects,and were divided into survival group(n-94)and death group(n=34)according to their survival conditions after 28 days.Univariate and multivariate Logistic regression analysis was used to investigate the risk factors affecting the prognosis of elderly patients with acute kidney injury in ICU.ResultsThere was no significant difference in sex,infection type,smoking and drinking,need for mechanical ventilation,sepsis grade,use of vasoactive drugs,and sequential organ failure(SOFA)score between the death group and the survival group(P>0.05).Age,the scores of acute physiology and chronic health status II(APACHE II)in the death group were higher than those in the survival group,and the grades of acute kidney injury were higher,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that age,APACHE I score and acute kidney injury grade were the risk factors for the prognosis of senile sepsis patients with acute kidney injury in ICU.Conclusion Age,APACHE II score and acute renal injury grade can be considered as the risk factors for the prognosis of senile sepsis patients with acute renal injury inICU.