Assessing the Risk of Delirium and Death in Sepsis Using the Braden Score: A Retrospective Study.

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing Pub Date : 2024-10-11 DOI:10.1111/jocn.17476

Xinya Li, Yonglan Tang, Zihong Bai, Xin Liang, Xiaxuan Huang, Jianguang Chen, Hongtao Cheng, Jun Lyu, Yu Wang

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引用次数: 0

Abstract

Aims and objectives: To provide a viable tool for the early clinical identification of high-risk populations in patients with sepsis.

Background: Sepsis-associated delirium (SAD) has the potential to significantly impact the short- and long-term prognosis of patients. However, accurately predicting and effectively managing SAD remains a significant challenge.

Methods: This study employed a retrospective analysis of adult sepsis patients admitted to the intensive care unit (ICU) for the first time. Patients were divided into two groups based on their initial Braden score upon admission to the ICU: a high-risk group (≤ 15 points) and a low-risk group (> 15 points). The relationship between Braden score and delirium was assessed using logistic regression and restricted cubic splines, while restricted mean survival time was employed to analyse the relationship between Braden scores and patients' 90- and 180-day mortality.

Results: Of the 28,312 patients included in the study, those in the high-risk group exhibited a significantly elevated risk of delirium (44.8% vs. 29.7%) and higher 90-day (28.7% vs. 19.4%) and 180-day (33.2% vs. 24.1%) mortality rates (all p < 0.001). After adjusting for confounding variables, logistic regression demonstrated that the risk of delirium was 1.54 times higher in the high-risk group (95% CI = 1.45-1.64, p < 0.001). Following propensity score matching, the difference in survival was statistically significant at both time points, with the high-risk group having a reduced survival rate of 7.50 days (95% CI = -8.24, -6.75; p < 0.001) and 15.74 days (95% CI = -17.40, -14.08; p < 0.001) at 90 days and 180 days, respectively.

Conclusions: The Braden score is a simple and effective tool for the early identification of patients at increased risk of adverse outcomes in sepsis.

Design: Retrospective study.

Relevance to clinical practice: The Braden score can be employed by clinical nurses for the purpose of early identification of poor prognostic risk in patients with sepsis.

Reporting method: This study was conducted according to the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.

Patient or public contribution: Patients were involved in the sample of the study.

查看原文本刊更多论文

使用布莱登评分评估败血症患者谵妄和死亡风险：一项回顾性研究

目的和目标背景：脓毒症相关谵妄（SAD）可能对患者的短期和长期预后产生重大影响：背景：脓毒症相关谵妄（SAD）可能对患者的短期和长期预后产生重大影响。然而，准确预测和有效管理 SAD 仍是一项重大挑战：本研究对首次入住重症监护室（ICU）的成人败血症患者进行了回顾性分析。根据患者进入重症监护室时的初始布莱登评分将其分为两组：高风险组（≤15分）和低风险组（>15分）。布莱登评分与谵妄之间的关系采用逻辑回归和限制性三次样条进行评估，而限制性平均生存时间则用于分析布莱登评分与患者90天和180天死亡率之间的关系：结果：在纳入研究的 28,312 名患者中，高危组患谵妄的风险显著升高（44.8% 对 29.7%），90 天（28.7% 对 19.4%）和 180 天（33.2% 对 24.1%）死亡率也较高（均为 p 结论：布莱登评分是一种简便易行的谵妄评分方法：布莱登评分是一种简单有效的工具，可用于早期识别脓毒症不良后果风险增加的患者：设计：回顾性研究：布莱登评分可用于临床护士早期识别脓毒症患者的不良预后风险：本研究根据加强流行病学观察性研究（STROBE）指南进行：患者参与了研究样本的采集。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.