某三级医院两种重症监护室呼吸机相关性肺炎患者的比较

İlken Uguz, Derya Karasu, Canan Yılmaz, G. Durmus, Ezgi ÜNAL ASAN, S. E. Ozgunay, M. Gamlı
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引用次数: 0

摘要

目的:我们的目的是比较在一家三级医院的两个不同的重症监护病房(icu)发生的呼吸机相关肺炎(VAP)患者的特征和30天死亡率。材料与方法:选取年龄在18岁以上,在我院两间不同icu就诊两年内发生VAP的患者作为研究对象。评估患者的急性生理和慢性健康评估II (APACHE II)、败血症相关器官衰竭评估(SOFA)、格拉斯哥昏迷评分(GCS)、临床肺部感染评分(CPIS)、感染标志物和30天死亡率。比较1组和2组患者身体状况、ICU手卫生率、护士文化程度、重症监护病房住院率。结果:共分析104例患者,其中组1 48例,组2 56例。两组患者在GKS、SOFA、CPIS评分方面差异无统计学意义。鲍曼不动杆菌是两组中最常见的致病菌。2组住院率明显高于对照组。第1组30天死亡率为45.8%,第2组为48.2%。结果发现,SOFA住院时间每增加一个单位,30天死亡的风险就会降低。结果表明,第2组年龄比每增加1个单位,30天死亡风险增加1.085倍,所有患者和第1组平均SOFA评分的增加缩短了住院时间。结论:我们发现诊断为VAP的患者30天死亡率为47.1%。SOFA评分的增加增加了30天死亡率的风险,而住院时间的延长则降低了死亡率的风险。
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Comparison of Patients with Ventilator-Associated Pneumonia Developed in Two Different Intensive Care Units of a Tertiary Hospital
Aim: Our purpose is to compare the characteristics and 30-day mortality of ventilator-associated pneumonia (VAP) patients that developed in two different intensive care units (ICUs) in a tertiary hospital. Material and Methods: Patients who were over the age of 18 who developed VAP in two different ICUs of our hospital over two years were included in the study. Acute Physiology and Chronic Health Assessment II (APACHE II), Sepsis-Related Organ Failure Assessment (SOFA), Glasgow Coma Score (GCS), Clinical Pulmonary Infection Score (CPIS), infection markers, and 30-day mortality of the patients were evaluated. Physical conditions of Group 1 and Group 2, hand hygiene rates in ICU, nurse education level, and hospitalization rate in intensive care units were compared. Results: A total of 104 patients, 48 being in Group 1 and 56 being in Group 2, were analyzed. There was no significant difference between the two groups with regards of GKS, SOFA and CPIS scores. Acinetobacter baumanni was the most common agent in both groups. The hospitalization rate was found to be significantly higher in Group 2. 30-day mortality was 45.8% in Group 1 and 48.2% in Group 2. It was found that a one unit increase in the SOFA hospitalization period reduced the risk of 30-day mortality. It was determined that a one unit increase in the age ratio in Group 2 increased the risk of 30-day mortality 1.085 times, and the increase in the mean SOFA score in all patients and Group 1 decreased the length of the hospitalization period. Conclusion: We found a 30-day mortality rate of 47.1% in patients diagnosed with VAP. An increase in SOFA score increases the risk of 30-day mortality, while a prolonged hospitalization period decreases the risk of mortality.
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