脓毒症患者入院时的年龄和住院时间可延长气管插管时间

Farshid Rahimibashar, A. vahedian-azimi, M. Salesi, Masoum Khosh Fetrat
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引用次数: 0

摘要

背景:气管插管(EI)联合机械通气(MV)是重症监护病房(ICU)重症脓毒症患者的常用手段。目的:本研究旨在评估脓毒症患者入院时气管插管时间的重要影响因素。方法:采用回顾性二次分析方法,对住院时需延长机械通气(PMV)时间(≥21天)的成年医外科混合ICU脓毒症患者进行分析。主要终点是ICU死亡率。通过单变量和多变量二元logistic回归,评估所有患者的基线人口统计学和临床特征作为与MV持续时间相关的危险因素。结果:85例患者需要21天以上的MV。85例患者中,52例(61.2%)患者在30 ~ 34.50天内插管,33例(38.8%)患者在34.51 ~ 65天内插管,分别分为PMV组和超长MV组。两个参数与超长MV有显著相关,分别是年龄1.229 (95% CI: 1.002 ~ 1.507, P=0.048)和住院时间(LOS) 2.996 (95% CI: 1.676 ~ 5.356, P<0.001)。两组患者的生存期无显著差异。(33.3% vs. 25%, P=0.406)。结论:我们的观察结果表明,年龄较大和住院时间较低的脓毒症阳性患者在ICU入院时可以延长插管时间。此外,PMV患者与极长时间MV患者的生存期无显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Age and the Length of Hospital Stay in Patients With Sepsis at the ICU Admission can Prolong the Duration of Endotracheal Intubation
Background: Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critically ill patients admitted to intensive care unit (ICU) with sepsis. Objectives: This study aimed to assess the impact of important factors on the duration of tracheal intubation in patients with sepsis at the ICU admission. Methods: Adult patients admitted to the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ 21 days) were included in this retrospective secondary analysis study. The primary outcome was ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with the duration of MV by univariate and multivariate Binary logistic regression. Results: Eighty-five patients required more than 21 days of MV. Out of the 85 patients, 52 (61.2%) patients were intubated within 30 to 34.50 days and 33 (38.8%) patients had intubation within 34.51 to 65 days, and categorized as PMV and very prolonged MV groups, respectively. Two parameters were significantly associated with very prolonged MV which are as follows: older age 1.229 (95% CI: 1.002-1.507, P=0.048) and long hospital stay (LOS) 2.996 (95% CI: 1.676-5.356, P<0.001). No significant survival difference was observed between the two groups of study. (33.3% vs. 25%, P=0.406). Conclusion: Our observations showed that the older age and LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV.
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