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在感染ED患者中,抗生素的时间和败血症的进展
Xiuzhen Lin1, Chen Liu1,2, Fengyu Chen3
1Department of General Practice, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
European journal of medical research
|February 6, 2026
概括
及时服用抗生素对于预防败血症至关重要. 在急诊室12小时以下的延迟可能不会显著增加败血症风险,但较长的延迟会增加. 需要进一步的研究.
科学领域:
- 紧急医疗 紧急医疗
- 传染性疾病 传染性疾病
- 临床结果研究研究
背景情况:
- 及时服用抗生素对于控制感染和预防败血症进展至关重要.
- 在急诊室 (ED) 治疗非败菌性感染的最佳抗生素时间尚不清楚.
- 这项研究调查了ED患者抗生素时间和败血症发展之间的联系.
研究的目的:
- 评估初始抗生素的时间和败血症的发展之间的关联.
- 评估抗生素延迟对医院死亡率和住院时间长度等二次结果的影响.
- 在怀疑感染时,为临床实践提供有关抗生素治疗方案的信息.
主要方法:
- 在三所三级护理ED的成年患者怀疑感染的回顾性队列研究 (2021年1月至2023年6月).
- 主要结局:败血症的发展. 二次结果:医院死亡率,ICU入院,住院时间 (LOS).
- 使用多变量回归分析,分析从ED到来到使用抗生素的时间.
主要成果:
- 包括1279名患者;20.5%患有败血症,10.3%进入ICU,3.8%的住院死亡率.
- 接受抗生素的中位时间为123分钟 (IQR 79-241).
- 超过12小时的延迟与败血症,死亡率和长期LOS (aORs>2.4,P <0.05) 的风险增加显著相关.
结论:
- 产生假设的发现表明,在不严重的感染中,在12小时内延迟可能是可以接受的,允许诊断澄清.
- 只有在延迟超过12小时时才观察到败血症风险和不良结果的显著增加.
- 为了证实这些关联,需要进行前性研究,因为这些关联是观测性质和潜在的偏差.
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