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临床特征和预测死亡率不同于肺部和腹部败血症
Enfeng Ren1, Hongli Xiao1, Jiebin Li2
1Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Shock (Augusta, Ga.)
|June 2, 2023
概括
肺性败血症患者面临的死亡率高于腹部败血症患者,有不同的预测因素,如肺性败血症的氧化和损伤和腹部败血症的严重程度等影响结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 肺部和腹部败血症表现出不同的病理生理学特征.
- 了解这些差异对于有针对性的治疗和改善患者结果至关重要.
研究的目的:
- 为了比较肺部和腹部败血症之间的临床特征和死亡预测指标.
- 在每个败血症子组中确定影响28天死亡率的特定因素.
主要方法:
- 一项多中心的回顾性研究,涉及1359名符合败血症-3标准的成年患者.
- 患者被分为肺部或腹部败血症组.
- 评估了血前素水平和严重性评分 (APACHE II,MEDS,SAPS II);记录了28天死亡率.
主要成果:
- 与腹部败血症相比,肺性败血症病例的28天死亡率,严重程度得分,休克发生率,急性损伤和成本都较高.
- 乳酸盐,APACHE II和MEDS分数预测了这两组人的死亡率.
- 肺性败血症死亡率预测因素包括PaO2/FiO2比率和急性损伤;腹部败血症预测因素包括SAPS II.
- 组合模型改善了每个子组的死亡率预测准确度.
结论:
- 肺性败血症与比腹部败血症更高的28天死亡率有关.
- 对于肺部和腹部败血症子组,存在不同的死亡预测因素.
- 冲击显著影响死亡率,在腹部败血症中观察到的效果更大.
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