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早期输管治疗对尿路塞普西斯患者中心结局的影响:一项回顾性多中心队列研究

Masafumi Suga^1,2,3, Ryan Ling^4,5,6, Sho Katsuragawa⁷

¹Department of Surgery Monash Health, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia. masafumi.suga@monash.edu.

Journal of intensive care

|October 24, 2025

概括

在ICU入院后24小时内,对尿路的早期输管治疗没有降低住院或长期死亡率. 这一发现表明,目前的时间准则可能不会显著影响这些重症患者的生存结果.

科学领域:

关键护理医学关键护理医学
传染性疾病传染性疾病
呼吸系统护理呼吸系统护理

背景情况:

尿道带有很高的死亡率 (高达13.5%),并且经常需要机械通风.
大约38%的泌尿突发症患者需要输管,这凸显了呼吸辅助管理的重要性.
在泌尿突发症中输管的最佳时间仍然是临床不确定性的领域.

研究的目的:

调查诊断出尿路塞psis的患者的输管时间和住院死亡率之间的关联.
评估早期 (≤24小时) 与延迟 (>24小时) 输内管对患者结局的影响.
评估二次结果,包括ICU和住院时间,以及长期死亡率.

主要方法:

使用澳大利亚和新西兰重症监护登记处成年患者数据库进行了一项多中心回顾性队列研究.
分析了在2018年1月至2023年4月期间入院的成年ICU患者 (≥16岁) 尿道炎症.
患者被分为早期 (≤24小时) 和延迟 (>24小时) 输管组,并使用多变量回归模型分析结果.

主要成果:

在1,235名患者中,79.6%接受了早期输管;在早期 (19.2%) 和延迟 (17.5%) 组 (p=0.52) 之间,住院死亡率相似.
早期输管与住院死亡率没有显著关联 (调整后OR=0.76;95%CI为0.51-1.13).
早期输管与更短的ICU停留时间 (LOS) 相关,但不是医院LOS,并且与6或12个月死亡率无关.

结论:

在因尿路塞psis 入院后24小时内开始输管治疗似乎没有改善住院生存率.
输尿管患者的输入管的时间不会显著影响6个月或12个月的长期死亡率.
这些发现表明,早期输管治疗可能不是尿路的生存的关键决定因素,尽管它可能会减少ICU LOS.

关键词:

在 ANZICS 成年患者数据库中.早期的输管管道化医院死亡率医院死亡率关于ICU的结果机械通风机械通风机械通风机泌尿突发症 (urosepsis) 是一种疾病,

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