Received:24 August 2016,
Published:28 February 2017
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Min Gao, Yu Sun, Yudi Wang, et al. Risk factors for sepsis in ICU trauma patients with infection[J]. J Third Mil Med Univ, 2017, 39(4): 367-372.
Min Gao, Yu Sun, Yudi Wang, et al. Risk factors for sepsis in ICU trauma patients with infection[J]. J Third Mil Med Univ, 2017, 39(4): 367-372. DOI: 10.16016/j.1000-5404.201608143.
Objective
2
To analyze the risk factors associated with the incidence of sepsis in intensive care unit (ICU) trauma patients with infection.
Method
2
A total of 227 trauma patients (174 males and 53 females) complicated by infection admitted in ICU of a Grade 3 Class A hospital from 2012 to 2015 in Chongqing were enrolled in this study. The patients were divided into sepsis group (
n
=168) and non-sepsis group (
n
=59) according to whether they were presented with sepsis. General information
injury score
infection status
and pathophysiological characteristics of all patients were recorded and analyzed using SPSS 17.0 to reveal the risk factors for sepsis.
Results
2
The incidence of sepsis in ICU trauma patients with infection accounted for 74.01%. Within 24 h of ICU admission
the patients in sepsis group had larger infusion volume
more frequent central catheterization and invasive mechanical ventilation
longer duration of the ventilation as compared to those in the non-sepsis group. Also they were more susceptible to infection of blood
wound
or surgery with higher injury scores including sequential organ failure score (SOFA)
injury severity score (ISS) and new injury severity score (NISS). The difference of these factors between the groups was statistically significant (
P
<
0.05). Logistic regression analysis revealed 7 risk factors associated with the incidence of sepsis for ICU trauma patients. The factors were SOFA score at hospital admission (
OR
=2.64
95%
CI
:1.27~5.46
P
=0.009)
increased number of dysfunctional system at ICU admission (
OR
=2.10
95%
CI
:1.35~3.27
P
=0.001)
abnormal blood pH value (
OR
=3.16
95%
CI
:1.43~6.99
P
=0.005) and average increase of pulse pressure (
OR
=1.52
95%
CI
:1.09~2.11
P
=0.014) within 24 h of ICU admission
presence of staphylococcus infection (
OR
=4.32
95%
CI
:1.54~12.07
P
=0.005)
presence of trauma or surgical site infection (
OR
=3.73
95%
CI
:1.12~12.46
P
=0.032)
and duration of invasive mechanical ventilation (
OR
=1.94
95%
CI
:1.36~2.77
P
<
0.01).
Conclusion
2
Infection is a prerequisite for ICU trauma patients developing sepsis. Strategies such as intensive monitoring the change of pH value and pulse pressure within 24 h of ICU admission
prevention of wound and surgical site infection
avoiding staphylococcus infection
reducing the duration of mechanical ventilation and so on may potentially reduce the incidence and mortality rate of sepsis in trauma patients.
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