越南败血症患者的患病率、死亡率和与死亡率相关的因素

IF 1.7 Q4 INFECTIOUS DISEASES
Luu Thi Thanh Duyen , Nguyen Thanh Viet , Ngo Thu Hang , Nguyen Anh Tuan , Le Van Khanh , Tran Viet Tien , Hoang Van Tong
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引用次数: 0

摘要

目的越南败血症的负担在很大程度上仍未得到证实。本研究旨在估计越南一家医院脓毒症患者的患病率和死亡率,并确定与死亡相关的因素。方法对脓毒症患者的临床特征、实验室特征及死亡率进行前瞻性观察研究。纳入了2018年10月至2020年12月期间因培养证实败血症而入住重症监护病房的所有患者。进行Logistic回归和受试者工作特征分析以确定死亡率预测因子。结果3890例入组患者中,2.7%(105例)为培养证实的脓毒症,其中64%(67/105)为脓毒症,36%(38/105)为感染性休克。总死亡率为52%(105人中55人),败血症死亡率为42%(67人中28人),感染性休克死亡率为71%(38人中27人)。大肠杆菌(38%)是最常见的分离病原体。尽管对碳青霉烯类和第三代头孢菌素的耐药性很高,但与死亡风险增加无关。Logistic回归分析确定神经功能障碍、合并症、血乳酸水平和急性器官功能障碍数量是整个队列中死亡率的独立预测因子(曲线下面积= 0.77)。在感染大肠杆菌或肺炎克雷伯菌的患者中,高血压、机械通气和肾功能障碍与死亡率独立相关(曲线下面积= 0.8)。结论越南败血症患者死亡率高,大肠杆菌是最常见的致病菌。神经功能障碍是死亡率的独立预测因子,而抗生素耐药性与较高的死亡率无关。确定的危险因素可能有助于指导早期临床干预,以改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence, mortality rate, and factors associated with mortality in patients with sepsis in Vietnam

Objectives

The burden of sepsis in Vietnam remains largely undocumented. This study aims to estimate the prevalence and mortality rate of sepsis and to identify mortality-associated factors among patients with sepsis in a Vietnamese hospital.

Methods

A prospective observational study was conducted to describe the clinical features, laboratory characteristics, and mortality rate of patients with sepsis. All patients admitted to intensive care units with culture-confirmed sepsis from October 2018 to December 2020 were included. Logistic regression and receiver operating characteristic analyses were conducted to identify mortality predictors.

Results

Of the 3890 enrolled patients, 2.7% (105 patients) had culture-confirmed sepsis, with 64% (67/105) classified as sepsis and 36% (38/105) as septic shock. The overall mortality rate was 52% (55 out of 105), with mortality rates of 42% (28 out of 67) for sepsis and 71% (27 out of 38) for septic shock. Escherichia coli (38%) was the most frequently isolated pathogen. Although resistance to carbapenems and third-generation cephalosporins was high, it was not associated with an increased risk of mortality. Logistic regression analysis identified neurologic dysfunction, comorbidities, blood lactate levels, and the number of acute organ dysfunctions as independent predictors of mortality in the overall cohort (area under the curve = 0.77). Among patients infected with E. coli or Klebsiella pneumoniae, hypertension, mechanical ventilation, and renal dysfunction were independently associated with mortality (area under the curve = 0.8).

Conclusions

Patients with sepsis in Vietnam exhibited a high mortality rate, with E. coli identified as the most common pathogen. Neurologic dysfunction was an independent predictor of mortality, whereas antibiotic resistance was not associated with higher mortality. The identified risk factors may help guide early clinical interventions to improve patient outcomes.
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来源期刊
IJID regions
IJID regions Infectious Diseases
CiteScore
1.60
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