败血症后再入院的风险因素及其与死亡率的关联
Milo Engoren1, Cynthia Arslanian-Engoren2
1Department of Anesthesiology, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, United States.
Heart & lung : the journal of critical care
|July 20, 2024
概括
败血症复发是很常见的,是由并发症和护理过程驱动的,而不是人口统计. 再入院的败血症患者面临着显著更高的90天死亡风险.
科学领域:
- 临床医学 临床医学
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 败血症对健康造成重大负担,其30天再入院率很高 (约. 20%) 和随后的死亡率.
- 了解影响败血症再入院的因素对于改善患者的治疗结果和降低医疗保健成本至关重要.
研究的目的:
- 为了确定与30天败血症再入院相关的人口因素,并发症,护理过程,实验室值和败血症后感染.
- 为了确定是否再入院是败血症幸存者的90天死亡率的独立风险因素.
主要方法:
- 分析了一个大型的患者数据库 (30,798) 符合败血症-3标准,分为构建和验证组.
- 后勤回归用于识别与30天再接收相关的因素.
- 使用比例危险回归来评估重新接收对90天死亡率的影响.
主要成果:
- 19%的败血症患者在30天内重新入院.
- 伴随性疾病,特定的护理过程 (例如,血小板输血,手术,ICU/住院时间),培养结果和出院实验室值与再入院有关.
- 再入院独立增加了90天死亡率的风险56%.
结论:
- 败血症再入院与并发症,护理过程和实验室发现有关,而不是人口统计数据.
- 败血症后的再入院显著提高了90天内死亡的风险.
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