首页|急诊重症监护室血流感染患者临床结局的风险因子探讨

急诊重症监护室血流感染患者临床结局的风险因子探讨

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目的 探讨急诊重症监护室(emergency intensive care unit,EICU)血流感染患者临床结局的风险因子,为临床决策提供依据.方法 回顾性收集 2019 年 1 月至 2023 年 4 月我院就诊的 141 例EICU血流感染患者的病历资料及血培养记录,采用Logistic回归分析患者死亡的危险因素,运用Cox回归分析上述因素与患者生存时间和临床结局的关系.结果 在 141 例EICU血流感染患者中,两种及以上细菌混合血流感染[比值比(OR)=5.68,95%置信区间(CI):1.20~26.98,P<0.05]及多重耐药菌血流感染(OR=6.39,95%CI:2.78~14.67,P<0.01)与患者死亡具有显著相关性;是否根据药敏结果及时调整用药[风险比(HR)=0.47,95%CI:0.30~0.74]和多重耐药菌血流感染(HR=2.02,95%CI:1.28~3.20)是EICU血流感染患者死亡的风险因子(P<0.01).结论 尽早采集血培养,明确感染病原菌,精准用药控制感染,可以有效降低患者的死亡率.
Investigation on risk factors for clinical outcomes of patients with bloodstream infections in the emergency intensive care unit
Objective To investigate the risk factors for the clinical outcomes of patients with bloodstream infections in emergency in-tensive care unit(EICU)and provide a basis for clinical treatment.Methods The medical records and blood culture records of 141 patients with bloodstream infections in the EICU of our hospital from January 2019 to April 2023 were retrospectively collected.The risk factors leading to patients′death were analyzed by the Logistic regression and the relationships between these factors and patients′sur-vival time and outcomes were evaluated by the Cox regression.Results Among the 141 patients with bloodstream infections in the EICU,the mixed bloodstream infections of two or more bacteria(odds ratio[OR]=5.68,95%confidence interval[CI]:1.20-26.98,P<0.05)and bloodstream infections of multidrug-resistant bacteria(OR=6.39,95%CI:2.78-14.67,P<0.01)were significantly cor-related with the patients′death.Whether to adjust medication in a timely manner based on drug sensitivity results(hazard ratio[HR]=0.47,95%CI:0.30-0.74)and bloodstream infections of multidrug-resistant bacteria(HR=2.02,95%CI:1.28-3.20)were the risk factors leading to the death of patients with bloodstream infections in the EICU(P<0.01).Conclusion Early blood culture to identify the pathogenic bacteria and precise medication to control infection can effectively reduce the mortality of patients with bloodstream in-fections in the EICU.

emergency intensive care unitbloodstream infectionblood culturemultiple drug resistant bacteriaprecision medica-tion

张培、邰萍、林康、李薇、金铃、何帮顺、蔺昕

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南京医科大学附属南京医院/南京市第一医院医学检验科,南京 210006

急诊重症监护室 血流感染 血培养 多重耐药菌 精准用药

江苏省医学重点学科建设单位项目

JSDW202239

2024

临床检验杂志
江苏省医学会

临床检验杂志

CSTPCD
影响因子:0.746
ISSN:1001-764X
年,卷(期):2024.42(5)
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