主要感染部位作为急诊室患者中败血症发展的预测因素
Jason D Vadhan1, Joby Thoppil1, Ofelia Vasquez2
1Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
The Journal of emergency medicine
|June 7, 2024
概括
预测败血症是一个挑战. 下呼吸道感染 (LRI) 和尿路感染 (UTI) 在急诊室患者中显著增加了败血症风险,住院和死亡率.
科学领域:
- 紧急医疗 紧急医疗
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 败血症构成重大威胁,但预测其发病和进展仍然很困难.
- 识别风险因素对于及时干预和改善患者结果至关重要.
研究的目的:
- 调查主要感染部位对急诊室 (ED) 患者败血症发展的影响.
- 评估感染源与临床结果 (包括死亡率) 之间的关联.
主要方法:
- 从2016年1月到2019年12月的ED患者数据的回顾性分析.
- 包括有记录上呼吸道 (URI),下呼吸道 (LRI),尿道 (UTI) 或皮肤/软组织感染的患者.
- 使用后勤回归来比较基于感染地点的结果的统计分析,以URI为参考.
主要成果:
- 下呼吸道感染 (LRI) 与败血症 (RRR 5.63) 和败血性休克 (RRR 21.2) 的相关性最高.
- LRIs也与增加住院 (OR 8.23),ICU入院 (OR 4.27),住院死亡率 (OR 6.93) 和30天死亡率 (OR 7.34) 相关.
- 尿路感染 (UTI) 与败血症和败血性休克有关,尽管比LRIs少.
结论:
- 主要感染的部位显著影响败血症的发展和患者的结果.
- 慢性肺炎和尿道感染是关键的感染源,与败血症,住院,长时间住院和死亡率的风险增加有关.
- 了解感染部位特定的风险可以为ED败血症管理策略提供信息.
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