出院后的毒症生存率:一个队列研究
Milo Engoren1, Michael D Maile1, Troy Seelhammer2
1From the Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
Anesthesia and analgesia
|October 18, 2023
概括
败血症幸存者面临着显著的出院后死亡率,受器官功能障碍和年龄等因素的影响. 这些风险随着时间的推移而变化,有些风险下降,有些风险增加,这凸显了持续监测的必要性.
科学领域:
- 关键护理医学 关键护理医学
- 流行病学 流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 败血症幸存者在出院后经历了较高的死亡率.
- 了解影响出院后死亡率的因素及其时间变化对于患者的治疗结果至关重要.
研究的目的:
- 估计与败血症幸存者出院后死亡率相关的因素.
- 分析这些关联在医院出院后随着时间的推移而变化.
主要方法:
- 对毒症的医院幸存者的回顾性研究.
- 利用时间变化的考克斯比例危险模型来评估死亡风险.
- 分析了危险比率 (HR) 和时间依赖的危险比率 (δHR),以捕捉时间效应.
主要成果:
- 在32244名败血症幸存者中,42%的患者在出院后死亡;随着时间的推移,死亡率下降.
- 排放时器官功能障碍 (例如,高尿素) 与更糟糕的存活率有关,随着时间的推移,相关性下降.
- 老年,医疗补助和医疗保险与死亡率增加有关,时间趋势各不相同.
结论:
- 急性生理障碍和器官功能障碍是出院后死亡率的关键预测因素.
- 这些因素对死亡率的影响随着时间的推移而减少.
- 长期监测和风险分层对于败血症幸存者至关重要.
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