Investigation of mortality predictors in general intensive care unit patients with nosocomial sepsis: A retrospective cohort study

Amaç: Nozokomiyal sepsis yoğun bakım ünitelerinde (YBÜ) mortaliteye katkıda bulunan ana faktörlerden biridir. Genel YBÜ'ndeki nozokomiyal sepsisli hastalarda mortalite belirteçleri araştırıldı.Yöntemler: Bu geriye yönelik çalışma 1 Ocak 2013 ve 1 Mayıs 2014 tarihleri arasında bir eğitim ve araştırma hastanesinin iki genel YBÜ'nde gerçekleştirildi. Hastaların tıbbi kayıtlari standart formlara kaydedildi. Toplamda, 83 hastada gelişen 95 sepsis atağı dahil edildi. Hasta tıbbi kayıtlarından elde edilen veriler standart formlara kaydedildi. Bulgular: Sepsis insidansı 100 YBÜ kabul başına 21,2 olguydu. Ortalama YBÜ'de kalış süresi 37,56±39,595 gündü. Hastaların, 43'ü (%51,8) erkek ve 40'ı (%48,2) kadındı. Yaşları 18 ile 90 (ortanca, 69±15,753) yıl arasında değişmekteydi. Medyan APACHE II skoru 26,9±6,4 idi. Kabul için temel nedenleri 62'sinde (%74,7) tıbbi sorunlar, 13'ünde (%15,7) seçmeli ameliyatlar ve 10'unda (%12,8) acil ameliyatlardı. Pnömoni (%80) YBÜ'de nozokomiyal sepsisli olguların çoğunluğunu oluşturuyordu. Pseudomonas aeruginosa (%24,6), Acinetobacter baumannii (%24,6) ve Klebsiella pneumoniae (%18,5) en sık izole edilmiş Alındığı tarih: 02.02.2016 mikroorganizmalardı. Nozokomiyal sepsis nedeniyle ölüm oranı %41'di. Sonuç olarak, çok değişkenli lojistik regresyon acil cerrahi (p=0,004), SOFA skorundaki artış (p=0,001) ve hemodiyaliz gerektirmiş akut böbrek yetmezliğinin (p=0,004) nozokomiyal sepsis nedeniyle ölüm için Kabul tarihi: 09.06.2016

Genel yoğun bakım ünitesindeki nozokomiyal sepsisli hastalarda mortalite belirteçlerinin araştırılması: Geriye yönelik bir kohort çalışması

Objective: Nosocomial sepsis is among the major factors contributing to mortality in intensive care units (ICUs). Mortality predictors in general ICU patients with nosocomial sepsis were investigated.Methods: This retrospective cohort study was conducted between January 1, 2013 and May 1, 2014 in two general ICUs of a training and research hospital. In total, 95 sepsis attacks developing in 83 patients were included in the study. Data from patients’ medical records were recorded on standardised forms.Results: Sepsis was detected in 21.2 cases per 100 ICU admissions. The median length of ICU stay was 37.56±39.595 days. Study population consisted of 43 (51.8%) male and 40 (48.2%) female patients. Their ages ranged from 18 to 90 (mean, 69±15.753) years. The median APACHE II score was 26.9±6.4 . The primary reasons for admission were medical problems in 62 (74.7%), elective surgeries in 13 (15.7%), and emergency surgeries in 10 (12.8%) patients. Pneumonia (80%) accounted for the majority of nosocomial cases of sepsis detected in the ICUs. Pseudomonas aeruginosa (24.6%), Acinetobacter baumannii (24.6%), and Klebsiella pneumoniae (18.5%) were the most frequently isolated microorganisms. Rate of mortality secondary to nosocomial sepsis was 41 percent. In conclusion, multivariate logistic regression showed that emergency surgery (p=0.004), an increase in the SOFA score (p=0.001), and haemodialysis required for acute renal failure (p=0.004) were statistically significant risk factors for mortality due to nosocomial sepsis.Conclusions: Monitoring SOFA scores may be useful for the monitorization of the patients with nosocomial sepsis

Kaynakça

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