The Clinical Value of Comprehensive Nursing Intervention in Preventing Severe Lymphopenia and Improving the Survival Rate Among Patients with Sepsis.

IF 1.5 Q3 EMERGENCY MEDICINE Open Access Emergency Medicine Pub Date : 2023-10-21 eCollection Date: 2023-01-01 DOI:10.2147/OAEM.S433980
Lin Zhang, Chao Xu, Lin Bai, Lin Li, Jinyan Guo, Yanyi Li
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Abstract

Background: Intensive care unit (ICU) patients with sepsis who experience severe lymphopenia are at a higher risk of mortality, and they serve as a more accurate indicator of bacteremia compared to traditional infection markers.

Aim: Our study aimed to examine the influence of severe lymphopenia on ICU mortality and outcomes in sepsis patients, while also evaluating the clinical significance of comprehensive nursing intervention in preventing severe lymphopenia.

Methods: Patients with sepsis in the ICU at our hospital between January 2015 and January 2021 were split into a control group and a test group.The control group received regular nursing care, while the test group was provided with comprehensive nursing care in addition to the control group. The results encompassed mortality rates of 28 days, mortality rates of 1 year, and lengths of stay in the ICU.

Results: Our attention was directed towards day 4 absolute lymphocyte counts, taking into account the receiver operating characteristic (ROC) outcome. Patients with severe lymphopenia were older, more patients with 2 above comorbidities, higher co-infection rates and SOFA score. In addition, patients with severe lymphopenia required longer days stay in ICU (P<0.001), and presented with higher 28-day mortality (P=0.038) and 1-year mortality (P=0.004). Patients in control group have a higher incidence of severe lymphopenia (P=0.006), 28-day mortality (P=0.015) and 1-year mortality (P=0.019) compared with the test group.

Conclusion: Comprehensive nursing intervention can prevent the occurrence of severe lymphopenia, improve patients satisfaction and reduce mortality.

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综合护理干预对预防脓毒症患者严重淋巴细胞减少及提高生存率的临床价值。
背景:重症监护室(ICU)脓毒症患者经历严重淋巴细胞减少症的死亡率更高,与传统的感染标志物相比,它们是更准确的菌血症指标。目的:我们的研究旨在探讨严重淋巴细胞减少症对败血症患者ICU死亡率和预后的影响,同时评估综合护理干预在预防严重淋巴细胞减少病中的临床意义。方法:将2015年1月至2021年1月在我院ICU的败血症患者分为对照组和试验组。对照组接受常规护理,试验组在对照组的基础上进行综合护理。结果包括28天的死亡率、1年的死亡率和在ICU的住院时间。结果:我们的注意力集中在第4天的绝对淋巴细胞计数上,考虑到受试者的操作特征(ROC)结果。严重淋巴细胞减少症患者年龄较大,有2种以上合并症的患者较多,合并感染率和SOFA评分较高。此外,严重淋巴细胞减少症患者需要更长的ICU住院天数(P=0.038)和1年死亡率(P=0.004)。与试验组相比,对照组患者的严重淋巴细胞减少病发生率(P=0.006)、28天死亡率(P=0.015)和1周死亡率(P=0.019)更高。结论:综合护理干预可预防严重淋巴细胞减少症的发生,提高患者满意度,降低死亡率。
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来源期刊
Open Access Emergency Medicine
Open Access Emergency Medicine EMERGENCY MEDICINE-
CiteScore
2.60
自引率
6.70%
发文量
85
审稿时长
16 weeks
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