急诊患者肺炎合并感染性休克的预后因素分析

Jong Won Kim, Jin Joo Kim, Hyuk-Jun Yang, Y. Lim, J. Cho, I. Hwang, Sang Hyun Han
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引用次数: 16

摘要

背景:在韩国传染病患者中,肺炎是最常见的死亡原因。然而,对急诊患者感染性休克合并肺炎的研究是有限的。本研究的目的是探讨急诊患者肺炎合并感染性休克的预后因素。方法:对2008年1月至2014年9月急诊收治的肺炎合并感染性休克患者进行回顾性分析。结果:561,845例急诊患者中,398例因肺炎合并感染性休克入院。这些患者28天死亡率为36.4%。独立预后因素为高龄(>70岁)(优势比[OR], 2.42;95%,可信区间[CI], 1.35-4.32),急性生理和慢性健康评估(APACHE) II评分(OR, 1.04;95% CI, 1.01-1.08),白细胞减少(OR, 3.63;95% CI, 1.48-8.94),延长PT-INR (OR, 2.53;95% CI, 1.41-4.54)和低氧血症(OR, 2.88;95% ci, 1.30-6.38)。结论:肺炎患者预后不良与老年(>70岁)、APACHEⅱ评分升高、白细胞减少、PT-INR延长和低氧血症相关。
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The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department
Background: Pneumonia is the most common cause of death among patients with infectious disease in Korea. However, studies of pneumonia with septic shock in patients presenting to the emergency department are limited. The aim of this study was to investigate the prognostic factors associated with pneumonia with septic shock in patients presenting to the emergency department. Methods: From January 2008 to September 2014, patients with pneumonia with septic shock admitted through the emergency department were retrospectively examined. Results: Of the 561,845 patients who visited the emergency department, 398 were admitted for pneumonia with septic shock. The 28-day mortality rate in these patients was 36.4%. The independent prognostic factors were old age (>70 yrs) (odds ratio [OR], 2.42; 95%, confidence interval [CI], 1.35–4.32), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR, 1.04; 95% CI, 1.01–1.08), leukopenia (OR, 3.63; 95% CI, 1.48–8.94), prolonged PT-INR (OR, 2.53; 95% CI, 1.41–4.54), and hypoxemia (OR, 2.88; 95% CI, 1.30–6.38). Conclusions: A poor prognosis of patients with pneumonia is associated with old age (>70 yrs), increased APACHE II score, leukopenia, prolonged PT-INR, and hypoxemia.
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