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在接受腹部手术的败血症患者中,累积90-D死亡率的预测因素
Shachi Srivatsa1, Courtney M Collins1, Whitney Kellett1
1Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio; Center for Translational Research in ACS, Critical Care, and Trauma Surgery (CTRACT), Division of Trauma, Critical Care and Burns, Department of Surgery, The Ohio State University Wexner Medical Center, The Ohio State University College of Medicine, Columbus, Ohio.
The Journal of surgical research
|April 29, 2025
概括
紧急手术患者的败血症的死亡率很高. 区域贫困指数 (ADI) 和临床因素预测死亡,强调在护理策略中需要社会决定因素.
科学领域:
- 关键护理医学 关键护理医学
- 手术瘤学手术瘤学
- 公共卫生 公共卫生
背景情况:
- 接受紧急整形手术的败血症患者面临着独特的挑战.
- 识别90天死亡率的预测因素对于这种独特的人群至关重要.
研究的目的:
- 为了确定临床和社会经济预测90天死亡率的性急诊整体外科患者.
- 分析这一群体中主要的死亡原因.
主要方法:
- 对498名患有败血症的患者进行了回顾性分析,这些患者接受了紧急腹内外科手术 (2011-2019).
- 评估人口统计,并发病,败血症严重程度 (SOFA分数) 和社会经济因素 (区域贫困指数 - ADI).
- 多重后勤回归用于识别死亡率的独立预测因素.
主要成果:
- 46%的患者在90天内死亡.
- 没有幸存者比较老,更频繁地转移,并具有更高的并发症得分和肝病,CKD和肥胖的发病率.
- 死亡率的关键预测因素包括SOFA得分,乳糖,肥胖,ADI,查尔森并发症指数和转移状态.
- 腹腔内灾难,多系统器官衰竭和肺部原因是导致死亡的主要原因.
结论:
- 腹内灾难,多系统器官衰竭和肺部并发症是主要的死亡原因.
- 区域贫困指数 (ADI) 是死亡率的重要社会经济预测指标.
- 将健康的社会决定因素纳入风险评估和护理策略是改善结果的关键.
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