根据感染地点在一组住院患者中发生败血症的临床表现
Adam R Schertz1, Ashley E Eisner1, Sydney A Smith2
1Department of Internal Medicine, Section of Pulmonology, Critical Care, Allergy & Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, NC.
Critical care explorations
|August 24, 2023
概括
败血症的呈现和结果因感染地点而异. 呼吸道和血管感染,以及未指定的部位,与其他感染部位相比,显示出更高的死亡率或休克风险.
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
- 流行病学 流行病学
背景情况:
- 败血症的表型是多样化的,受感染部位,器官功能障碍和患者因素的影响.
- 关于感染部位如何影响败血症标志物时间和呈现的研究有限.
- 这项研究调查了基于感染地点的败血症临床标志物和结果的变化.
研究的目的:
- 为了确定败血症的临床标志物和结果是否因感染部位而异.
- 为了确定特定的感染部位与增加的败血症严重程度和死亡率相关.
- 分析与感染部位相关的败血症标志物阳性 (SIRS,qSOFA,SOFA) 的时间.
主要方法:
- 这是一项回顾性队列研究,涉及五家医院的6,753名成年患者.
- 患者符合系统炎症反应综合征 (SIRS),快速败血症相关器官衰竭评估 (qSOFA) 或顺序器官衰竭评估 (SOFA) 的标准.
- 感染地点被分类,并分析了结果 (30天死亡率或休克),并根据相关因素进行调整.
主要成果:
- 在感染地点之间观察到显著的人口统计学,生命体征和实验室差异.
- 未知/未指明的感染有最高的复合结局率 (21.34%),而中枢神经系统感染是最低的 (8.11%).
- 呼吸道,血管和未知/未指定的感染显示,30天死亡率或休克率显著更高.
结论:
- 败血症根据感染部位表现出显著的表型变异,影响疾病严重程度和死亡率.
- 呼吸道,血管和未知/未指定的感染与较高的死亡或休克风险有关.
- 了解特定部位的败血症表型对于有针对性的临床管理和改善患者治疗结果至关重要.
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