在败血症住院和相关结果中,外周动脉疾病的流行率
Stuthi Iyer1, Marissa C Jarosinski2, Jason N Kennedy1
1Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Journal of vascular surgery
|May 4, 2025
概括
周围动脉疾病 (PAD) 显著增加了败血症死亡率和截肢风险. 抗血栓治疗可以减轻这些不良结果在住院治疗血症与动脉样硬化心血管疾病 (ASCVD) 的患者.
科学领域:
- 心血管医学 心血管医学
- 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:
- 败血症是一种危及生命的疾病,通常由诸如动脉样硬化心血管疾病 (ASCVD) 等并发症加重.
- 虽然冠状动脉疾病 (CAD) 是已知的危险因素,但对外周动脉疾病 (PAD) 和败血症结局的数据有限.
- 了解ASCVD,特别是PAD对败血症住院的影响,对于改善患者护理至关重要.
研究的目的:
- 为了确定ASCVD在成人败血症住院患者中的患病率.
- 评估ASCVD和住院死亡率之间的关联.
- 评估ASCVD与四肢结局之间的联系,特别是严重或转移性足截肢,在败血症患者中.
主要方法:
- 利用国家住院患者样本 (2016-2020年) 确定成人败血症住院病例.
- 使用考克斯回归模型分析ASCVD,住院死亡率和截肢风险之间的关联.
- 调整为人口因素和并发性疾病,并对抗血栓治疗使用进行了子组分析.
主要成果:
- 在9.5%的败血症住院患者中诊断出PAD,并与18%的住院死亡风险增加有关.
- PAD显著增加了四倍以上的重大或转移足截肢的风险.
- 结合ASCVD的患者面临着最高的死亡风险,而PAD强烈预测截肢,甚至比结合ASCVD更强.
结论:
- 患有ASCVD的败血症患者,尤其是PAD患者,面临死亡和肢体截肢的风险要高得多.
- 抗血栓治疗表明,在患有PAD的败血症患者中,有潜力降低死亡率和截肢风险.
- 在败血症患者中优化ASCVD的医疗管理可能会导致改善临床结果.
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