安徽省ICU脓毒症流行病学特点及预后影响因素  

Epidemiological characteristics and prognostic factors influencing the sepsis in ICUs of Anhui province

作　　者：刘林 汤家才 刘杰 缪夕友 张洁[5] 王翠 王珩[6] 邵敏[1] Liu Lin;Tang Jiacai;Liu Jie;Miao Xiyou;Zhang Jie;Wang Cui;Wang Heng;Shao Min(Department of Intensive Care Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院重症医学科,安徽合肥230022 [2]来安县人民医院重症医学科,安徽滁州239200 [3]太和县人民医院重症医学科,安徽滁州233199 [4]凤阳县人民医院重症医学科,安徽滁州233199 [5]安徽医科大学第一附属医院信息中心,安徽合肥230022 [6]安徽医科大学第一附属医院健康大数据与群体医学研究所,安徽合肥230022

出　　处：《中国急救医学》2024年第12期1092-1098,共7页Chinese Journal of Critical Care Medicine

基　　金：大健康研究院健康人数据与群体医学研究所专项资金资助(JKS2022002);安徽省科技厅重点研究与开发计划项目(2022e07020039)。

摘　　要：目的探讨安徽省二级以上医院重症监护病房(ICU)脓毒症的流行病学特征并分析影响脓毒症患者预后的危险因素。方法对安徽省二级以上综合性公立医院ICU的所有在院患者(2022年5月6日8:00AM至2022年6月6日8:00AM)进行筛选,记录了28 d或死亡患者的人口学信息、生化指标、微生物学数据及临床干预措施。经过单因素和多因素Logistic回归分析影响脓毒症患者28天病死率的危险因素。结果全省共77个ICU 2383例患者纳入了本研究,其中脓毒症患者440例(18.5%)。脓毒症最常见的感染部位是呼吸系统(55.6%),其次是腹腔(38.8%)和泌尿系统(11.8%),检出致病菌中一半以上为革兰染色阴性菌。ICU患者28天病死率为26.9%,其中脓毒症患者病死率为41.4%。影响脓毒症患者28天病死率的危险因素包括年龄、序贯器官衰竭评分(SOFA)及尿素氮。结论安徽省各级ICU中脓毒症患者病死率偏高,寻找预后危险因素,积极防治任重道远。Objective To explore the epidemiological characteristics of sepsis in ICUs of secondary level or above hospitals in Anhui province and to analyse the risk factors affecting the prognosis of septic patients.Methods All the patients in ICUs of secondary level or above comprehensive public hospitals in Anhui province(from 8:00 AM on May 6,2022 to 8:00 AM on June 6,2022)were screened,and demographic information,biochemical indexes,microbiological data and clinical interventions of the patients who had been in the ICUs for 28 days or died were recorded.Risk factors affecting the 28-day prognosis of the patients were analysed by univariate and multivariate Logistic regression.Results A total of 2383 ICU patients from 77 units in Anhui province were included in this study,of whom 440(18.5%)patients were septic.The most common site of infection was the lungs(55.6%),followed by the abdominal cavity(38.8%)and the urinary system(11.8%),and more than half of the detected causative organisms were Gram-negative bacteria.The 28-day mortality rate of ICU patients was 26.9%,of which the mortality rate of septic patients was 41.4%.Risk factors for 28-day mortality in septic patients included age,sequential organ failure assessment(SOFA)score and urea nitrogen.Conclusions The mortality rate of septic patients in ICUs at all levels in Anhui province is on the high side.It is a long way to find out the risk factors of death and actively prevent and treat them.

关 键 词：脓毒症 流行病学 病原菌 预后 序贯器官衰竭评分 血尿素氮 年龄 

分 类 号：R459.7[医药卫生—急诊医学]