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脓毒症患者疾病预后的影响因素及预测模型构建

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目的 探究脓毒症患者疾病预后的影响因素及预测模型构建.方法 选择2021年2月至10月浙江省丽水市中心医院就诊的脓毒症患者165例,根据其28 d预后情况将其分为预后良好组(122例)及预后不良组(43例),收集患者资料,采用logistic回归方程分析脓毒症患者疾病预后的影响因素并构建预测模型,绘制受试者,操作特征曲线分析模型的预测价值.结果 两组氧合指数、D-二聚体(D-D)、C反应蛋白(CRP)、感染相关器官衰竭评分(SOFA)、急性生理与慢性健康状况评分Ⅱ比较,差异有统计学意义(P<0.05);多因素分析显示,D-D(OR=2.195)、CRP(OR=1.855)、SOFA评分(0R=2.489)是脓毒症患者预后的独立危险因素(P<0.05),氧合指数(OR=0.571)是脓毒症预后的保护因素(P<0.05).受试者操作特征曲线分析显示,氧合指数、D-D、CRP、SOFA评分对脓毒症预后的曲线下面积分别为0.825、0.785、0.721、0.834.结论 D-D、CRP、SOFA评分是脓毒症患者预后的独立危险因素,氧合指数是脓毒症预后的保护因素,临床根据这些影响因素来进行针对性护理有助于改善患者预后.
Influencing factors of disease prognosis and construction of prediction model in patients with sepsis
Objective To explore the influencing factors of disease prognosis and construction of prediction model in patients with sepsis.Methods A total of 165 patients with sepsis treated in Lishui Central Hospital were enrolled from February to October 2021,according to 28 d prognosis,they were divided into good prognosis group(122 cases)and poor prognosis group(43 cases).The data of patients were collected.The influencing factors of disease prognosis in sepsis patients were analyzed by logistic regression equation,and the prediction model was constructed.The receiver opera-tor characteristic cure was drawn to analyze the predictive value of model.Results There were significant differences in oxygenation index,D-dimer(D-D),C-reactive protein(CRP),scores of sequential organ failure assessment(SOFA),and acute physiology and chronic health evaluation Ⅱ be-tween the two groups(P<0.05).Multivariate analysis showed that D-D(OR=2.195),CRP(OR=1.855),and SOFA score(OR=2.489)were inde-pendent risk factors of prognosis in sepsis patients(P<0.05),while oxygenation index(OR=0.571)was a protective factor of prognosis in sepsis pa-tients(P<0.05).The area under the receiver operator characteristic curve of oxygenation index,D-D,CRP,and SOFA score for the prognosis of sepsis was 0.825,0.785,0.721,and 0.834,respectively.Conclusion D-D,CRP,and SOFA score are independent risk factors of prognosis,while oxygenation index is protective factor in patients with sepsis.Clinically,targeted nursing based on these influencing factors is beneficial to improve prognosis of patients.

SepsisOxygenation indexD-dimerC-reactive proteinScore of sequential organ failure assessment

范良梅、赵荣美、吴芬、刘赟

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浙江省丽水市中心医院59病区感染科2,浙江丽水 323000

脓毒症 氧合指数 D-二聚体 C反应蛋白 序贯器官衰竭评分

浙江省医药卫生科技计划项目

2020ZH013

2024

中国医药导报
中国医学科学院

中国医药导报

CSTPCD
影响因子:1.759
ISSN:1673-7210
年,卷(期):2024.21(16)