目的 探讨脓毒症存活患者认知功能障碍的发生现状,分析脓毒症存活患者认知功能障碍的影响因素.方法 回顾性选取2022年1月～2023年12月在新疆维吾尔自治区人民医院急救中心治疗并存活出院的脓毒症患者.根据长沙版蒙特利尔认知量表(Montreal cognitive assessment,MoCA)将患者分为认知功能障碍组和非认知功能障碍组,分析脓毒症存活患者认知功能障碍的独立影响因素.结果 共纳入190例脓毒症存活患者,其中男性106例(55.79％),认知功能障碍组91例(47.9％);单因素分析结果显示:年龄、ICU住院时间、qSOFA评分、SOFA评分、APACHE Ⅱ评分、WBC、乳酸、BNP、D-二聚体、文化程度等指标在两组间比较,差异有统计学意义(P＜0.05);多因素Logistic回归分析结果显示,年龄(OR=1.037,95％CI:1.004～1.072)、重症监护室(intensive care unit,ICU)住院时间(OR=1.074,95％CI:1.001～1.149)、血氨(OR=1.023,95％CI:1.007～1.039)、快速序贯器官衰竭评估(quick sequential organ failure assessment,qSOFA)评分(OR=1.781,95％CI:1.113～2.851)和文化程度(初中:OR=0.190,95％CI:0.050～0.721;高中及中专:OR=0.105,95％CI:0.023～0.484;大专及以上:OR=0.083,95％CI:0.017～0.408)是脓毒症存活患者认知功能的独立影响因素.结论 年龄、ICU住院时间、血氨、qSOFA评分是脓毒症存活患者认知功能障碍的危险因素,而文化程度是保护因素.
Analysis of Factors Influencing Cognitive Dysfunction in Sepsis Survivors
Objective To investigate the current incidence of cognitive dysfunction in sepsis survivors and analyze the factors influ-encing cognitive function in these patients.Methods Patients treated for sepsis and discharged from the Emergency Center of the People's Hospital of the Xinjiang Uygur Autonomous Region between January 2022 and December 2023 were selected retrospectively.Based on the Changsha version of the Montreal cognitive assessment(MoCA),these patients were categorized into groups with and without cognitive dysfunction,to analyze the independent influencing factors of cognitive dysfunction in sepsis survivors.Results A total of 190 patients were included in the study,of which 106 patients were male(55.79％),and 91(47.9％)patients were identified with cognitive dys-function.Univariate analysis showed that there were significant differences in age,ICU length of stay,qSOFA score,SOFA score,A-PACHE Ⅱ score,WBC,lactate,BNP,D dimer and education level between the two groups(P＜0.05).Multivariate Logistic regression analysis revealed that age(OR=1.037,95％CI:1.004-1.072),length of intensive care unit(ICU)stay(OR=1.074,95％CI:1.001-1.149),blood ammonia levels(OR=1.023,95％CI:1.007-1.039),qSOFA score(OR=1.781,95％CI:1.113-2.851)and educational level(junior high school:OR=0.190,95％Cl:0.050-0.721;high school and vocational school:OR=0.105,95％CI:0.023-0.484;college and above:OR=0.083,95％CI:0.017-0.408)were independent factors influencing cogni-tive function in sepsis survivors.Conclusion Age,length of ICU stay,blood ammonia levels,and qSOFA score were identified as risk factors for cognitive dysfunction in sepsis survivors,whereas educational level served as a protective factor.
万方数据
维普
