ICU创伤后感染患者并发脓毒症的危险因素分析

高敏; 孙宇; 王宇迪; 夏晚秋; 梁华平; 张绍蓉

doi:10.16016/j.1000-5404.201608143

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ICU创伤后感染患者并发脓毒症的危险因素分析

基础医学 | 更新时间：2026-01-09

- ICU创伤后感染患者并发脓毒症的危险因素分析
- Risk factors for sepsis in ICU trauma patients with infection
- 第三军医大学学报 2017年39卷第4期页码：367-372
- 作者机构：
- 作者简介：
- 基金信息：
  
  军队十二五重点项目(BWS11J038)
- DOI：10.16016/j.1000-5404.201608143
  中图分类号：
- 收稿：2016-08-24，
  
  纸质出版：2017-02-28
- 稿件说明：
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高敏, 孙宇, 王宇迪, 等. ICU创伤后感染患者并发脓毒症的危险因素分析[J]. 第三军医大学学报, 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.
高敏, 孙宇, 王宇迪, 等. ICU创伤后感染患者并发脓毒症的危险因素分析[J]. 第三军医大学学报, 2017,39(4):367-372. DOI： 10.16016/j.1000-5404.201608143.

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.

摘要

Abstract

Objective

To analyze the risk factors associated with the incidence of sepsis in intensive care unit (ICU) trauma patients with infection.

Method

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 (

=168) and non-sepsis group (

=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

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 (

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 (

=2.64

95%

:1.27~5.46

=0.009)

increased number of dysfunctional system at ICU admission (

=2.10

95%

:1.35~3.27

=0.001)

abnormal blood pH value (

=3.16

95%

:1.43~6.99

=0.005) and average increase of pulse pressure (

=1.52

95%

:1.09~2.11

=0.014) within 24 h of ICU admission

presence of staphylococcus infection (

=4.32

95%

:1.54~12.07

=0.005)

presence of trauma or surgical site infection (

=3.73

95%

:1.12~12.46

=0.032)

and duration of invasive mechanical ventilation (

=1.94

95%

:1.36~2.77

0.01).

Conclusion

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.

关键词

Keywords

references

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