岭南急诊医学杂志2024,Vol.29Issue(4) :322-324,361.DOI:10.3969/j.issn.1671-301X.2024.04.003

脓毒症相关急性呼吸窘迫综合征危险因素分析:一项回顾性队列研究

Risk Factor Analysis for Sepsis-associated Acute Respiratory Distress Syndrome:a Retrospective Cohort Study

易小玲 曾国琼 陈慧 顾杨 李莉 余涛
岭南急诊医学杂志2024,Vol.29Issue(4) :322-324,361.DOI:10.3969/j.issn.1671-301X.2024.04.003

脓毒症相关急性呼吸窘迫综合征危险因素分析:一项回顾性队列研究

Risk Factor Analysis for Sepsis-associated Acute Respiratory Distress Syndrome:a Retrospective Cohort Study

易小玲 1曾国琼 1陈慧 1顾杨 1李莉 1余涛1
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作者信息

  • 1. 中山大学孙逸仙纪念医院急诊科(510000)
  • 折叠

摘要

目的:多项指标联合构建脓毒症相关急性呼吸窘迫综合征(ARDS)的预测模型.方法:收集2018年3月至2022年10月中山大学孙逸仙纪念医院303例脓毒症患者的临床资料,采用单因素和多因素Logistic回归分析筛选ARDS发生的独立危险因素,构建ARDS发生的预测模型.结果:303例患者中,ARDS组145例,非ARDS组158例,两组在氧合指数、血氧、尿素氮、舒张压、白蛋白、SOFA评分、脓毒性休克、肺部及泌尿系感染等方面具有显著差异(P<0.05).多因素回归分析示舒张压、白蛋白、氧合指数、肺部感染及脓毒性休克与ARDS发生独立相关.ARDS联合预测模型曲线下面积为0.812(95%CI 0.76-0.86),敏感度为69.7%,特异度为 84%.结论:联合指标构建的ARDS预测模型具有较好的预测效能,有助于患者的临床诊治.

Abstract

Objective:To construct a predictive model for sepsis associated-acute respiratory distress syndrome(ARDS)by combining multiple indicators.Methods:We performed a retrospective analysis of the medical records of pa-tients with sepsis at the Sun Yat-sen Memorial Hospital from March 2018 to October 2022.Univariate and multivariate Lo-gistic regression were performed to identify the independent risk factors of ARDS,and then a joint prediction model was constructed based on the results of multivariate regression analysis.Results:A total of 303 patients were en-rolled in this study which including 145 patients with ARDS and 158 patients without ARDS.There was statistical signifi-cance between the two groups of patients(P<0.05)in terms of oxygenation index,blood oxygen,urea nitrogen,dia-stolic blood pressure,albumin,SOFA score,septic shock,pulmonary and urinary tract infections.Multivariate logis-tic regression analysis showed that albumin,oxygenation index,diastolic blood pressure,septic shock and pulmonary in-fection were independent predictors for the occurrence of septic ARDS.The area under the curve of the ARDS joint predic-tion model is 0.812(95%CI 0.76-0.86),the sensitivity is 69.7%,and the specificity is 84%.Conclusion:The ARDS prediction model constructed by combining indicators has good predictive performance,which is helpful for the clinical diagnosis and treatment of patients.

关键词

急性呼吸窘迫综合征/脓毒症/危险因素/预测模型/血清学指标

Key words

acute respiratory distress syndrome/sepsis/risk factor/predictive model/serological indicators

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基金项目

广东省医学科研基金(A2023079)

广东省广州市科技计划项目(2024A03J1188)

出版年

2024
岭南急诊医学杂志
广东省医学会

岭南急诊医学杂志

影响因子:0.437
ISSN:1671-301X
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