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败血性休克和胆道败血症:90天死亡率和相关风险因素
Pierre Thibaud1, Laurent Chow-Chine1, Frédéric Gonzalez1
1Intensive Care Unit, Paoli-Calmettes Institute, Marseille, France.
概括
癌症患者的胆管败血症具有有利的90天死亡率. 转移阶段和多药耐药细菌等因素会影响生存,但抗生素降级 (ADE) 似乎是安全的.
科学领域:
- 关键护理医学 关键护理医学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 胆管败血症是患有消化道癌症的患者经常出现的并发症.
- 建议在败血症和败血性休克管理中进行抗生素降级 (ADE).
- 这项研究调查了影响死亡率的因素以及AEE对这一群体的影响.
研究的目的:
- 确定胆道败血症或败血症休克患者90天死亡率的预测因素.
- 评估抗生素降级 (ADE) 在这个队列中的安全性和影响.
主要方法:
- 从2008年11月到2019年12月在癌症转诊中心进行的回顾性研究.
- 包括入住重症监护室 (ICU) 的患有胆道败血症或败血性休克的成年患者.
- 用单变量和多变量考克斯比例危险模型来确定与90天死亡率相关的因素.
主要成果:
- 在122名患者中,90天死亡率为30.3%.
- 死亡率的独立预测因素包括转移阶段,胆道瘤压缩,ICU入院时携带多种耐药细菌,血清乳酸水平升高,需要外置换,V因子水平低,表现不佳 (ECOG-PS>2).
- 抗生素降级 (ADE) 和最近的癌症手术与改善的生存率有关.
结论:
- 在癌症患者中,胆道败血症的90天死亡率似乎可以控制.
- 死亡率与器官功能障碍,性能状况,癌症阶段和多药耐药细菌殖民有关.
- 抗生素降级 (ADE) 是这种患者群体的安全策略.
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