预测急诊科疑似败血症老年患者 28 天死亡率的因素

IF 0.8 4区 医学 Q4 EMERGENCY MEDICINE Hong Kong Journal of Emergency Medicine Pub Date : 2024-05-12 DOI:10.1002/hkj2.12023
Pitsucha Sanguanwit, C. Yuksen, J. Khorana, Yuranun Phootothum, Siriporn Damdin, Krongkarn Sutham
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引用次数: 0

摘要

老年患者面临的败血症风险增加,急诊科(ED)需要精确的预后工具。本研究旨在探讨预测急诊科疑似败血症老年患者(≥60 岁)28 天死亡率的因素。研究收集了2018年10月1日至2018年12月31日期间所有到急诊科就诊的临床疑似败血症老年患者的数据。使用单变量和多变量 Cox 回归分析了预后因素、特征、合并症、分诊时的生命体征、急诊严重程度评分、初始实验室结果和脓毒症捆绑治疗。共纳入了 329 名老年疑似败血症患者。28天的总死亡率为10.33%。与 28 天死亡率显著相关的独立预后因素是恶性肿瘤(调整后危险比 [aHR]:3.67;95% 置信区间 [CI]:1.90, 7.09; p < 0.01)、血氧饱和度 ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p < 0.01) 和依赖状态(危险比 [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02)。该研究表明,"MOD"、M-恶性肿瘤、O-氧饱和度≤93%和D-依赖状态是影响急诊室疑似败血症老年患者28天死亡率的重要预后指标。该试验于2022年5月6日在泰国临床试验登记处进行了回顾性登记,登记号为TCTR20220506006。
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Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department
Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED.We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28‐day mortality.A total of 329 older patients with suspected sepsis were included. The overall 28‐day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28‐day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p < 0.01), oxygen saturation ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p < 0.01), and dependent status (hazard ratio [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02).This study suggests that “MOD”; M‐Malignancy, O‐Oxygen saturation ≤93%, and D‐Dependent status are significant prognostic indicators for 28‐day mortality among older patients with suspected sepsis in the ED.The trial was retrospectively registered in the Thai Clinical Trial Registry on 06/05/2022, identification number TCTR20220506006.
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来源期刊
CiteScore
1.50
自引率
16.70%
发文量
26
审稿时长
6-12 weeks
期刊介绍: The Hong Kong Journal of Emergency Medicine is a peer-reviewed, open access journal which focusses on all aspects of clinical practice and emergency medicine research in the hospital and pre-hospital setting.
期刊最新文献
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