老年重症肺炎合并脓毒性休克患者预后影响因素分析

Analysis of Prognostic Factors in Elderly Patients with Severe Pneumonia and Septic Shock

目的分析影响老年重症肺炎合并脓毒性休克患者预后的相关影响因素。方法研究时间定于2020年1月—2023年12月,研究对象选择于我院采取综合检查确诊为重症肺炎合并脓毒性休克的患者50例,收集患者临床资料、住院时间、基础疾病、实验室检查结果,根据患者存活情况分为死亡组、存活组,分析影响老年重症肺炎合并脓毒症休克患者预后的影响因素以及独立危险因素。结果两组患者性别、年龄、血小板计数、EICU住院时间、合并基础性疾病、白细胞计数、血红蛋白水平等指标对比结果无差异(均P>0.05);与存活组相比,病死组急性生理与慢性健康状况评分(APACHEⅡ评分)、血清肝素结合蛋白(HBP)、动脉血乳酸水平、红细胞分布宽度(RDW)较高,D-二聚体水平(D-D)、△PCT5(procalcitonin 5)水平以及序贯器官衰竭的检测评分(SOFA)较低,均为老年重症肺炎合并脓毒性休克患者的预后影响因素(均P<0.05);多因素Logistic回归分析:APACHEⅡ评分、血清HBP、动脉血乳酸水平、RDW、△PCT5、D-D、SOFA评分均属于患者预后的危险因素,OR值均>1。结论老年重症肺炎合并脓毒性休克患者的预后受诸多因素影响,包含APACHEⅡ评分、血清HBP、动脉血乳酸水平、RDW、△PCT5、D-D、SOFA评分等,针对上述影响因素采取对应干预措施能够提高患者生存质量。

Objective To analyze the relevant influencing factors on the prognosis of elderly patients with severe pneumonia combined with septic shock.Methods The study period is scheduled from January 2020 to December 2023,and the study subjects were selected from 50 patients who were diagnosed as severe pneumonia combined with septic shock by comprehensive examination in our hospital,and the patients'clinical data,hospitalization time,underlying diseases,and laboratory test results were collected,and the patients were divided into the death group and the survival group according to the survival status of the patients.To analyze the influencing factors as well as independent risk factors affecting the prognosis of elderly patients with severe pneumonia combined with septic shock.Results There was no difference in the comparison results of gender,age,platelet count,EICU hospitalization time,comorbid underlying diseases,white blood cell count,hemoglobin level and other indexes between the two groups(all P>0.05);Compared with the survival group,the acute physiological and chronic health status score(APACHEⅡscore),serum heparin-binding protein(HBP),arterial blood lactate level,and red blood cell distribution width(RDW)were higher,and the D-dimer level(D-D),△PCT5(procalcitonin 5)level,and SOFA score were lower in the case of the diseased and dead group,which were the prognostic factors of elderly patients with severe pneumonia combined with septic shock patients'prognostic influences(all P<0.05),multifactorial logistic regression analysis:APACHEⅡscore,serum HBP,arterial blood lactate level,RDW,ΔPCT5,D-D,and SOFA scores were all risk factors for the patients'prognosis,and the OR values were all>1.Conclusions The prognosis of elderly patients with severe pneumonia combined with septic shock is affected by many factors,including APACHE II score,serum HBP,arterial blood lactate level,RDW,△PCT5,D-D and SOFA scores.Interventions targeting the above influencing factors can improve the quality of patients'survival.