Early risk factors for sepsis in patients with severe blunt trauma
Early risk factors for sepsis in patients with severe blunt trauma
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DOI：
10.1016/s0020-1383(00)00103-0
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发表时间：
2001-01-01
影响因子：
2.5
通讯作者：
Murillo, F
中科院分区：
文献类型：
--
作者：
Flores, JM;Jiménez, PI;Murillo, F
我们研究了43例钝性创伤（损伤严重度评分，大于或等于25），年龄> 14岁，重症监护室（ICU）停留时间> 48小时的患者，以估计脓毒症的频率并确定与其发展相关的早期风险因素。在前24小时内收集临床数据，并从损伤后前2天的血清样品中测定几种炎症介质。（48.8%）在ICU住院期间符合脓毒症标准，9（20.9%）仅符合脓毒症标准; 6（13.9%）符合严重脓毒症标准，（13.9%）脓毒性休克的标准。APACHE II评分大于或等于14，存在低血容量性休克，需要输注三个或更多单位的血液和给予总体积大于或等于10 L的流体都是与脓毒症的发展显著相关的因素。在多变量分析中，液体总体积大于或等于10 L的需求是唯一的独立风险因素（调整后的比值比= 10.49，95%CI，2.34-47.02; P = 0.002）。未记录与血清标志物行为相关的显著差异。(C)2001爱思唯尔科技有限公司版权所有。
We studied 43 patients with blunt trauma (injury severity score, greater than or equal to 25), age > 14 years and length of the intensive care unit (ICU) stay > 48 h in order to estimate the frequency of sepsis and to identify early risk factors related to its development. Clinical data were collected during the first 24 h and several inflammatory mediators were determined from serum samples of the first 2 days after injury.Twenty-one patients (48.8%) met sepsis criteria during their ICU stay, 9 (20.9%) fulfilled only criteria for sepsis; 6 (13.9%) fulfilled criteria for severe sepsis and another 6 (13.9%) criteria for septic shock.An APACHE II score greater than or equal to 14, the presence of hypovolemic shock, the need for three or more units of blood to be transfused and the administration of a total volume of fluids greater than or equal to 10 l were all factors associated significantly with the development of sepsis. In the multivariant analysis, the need for a total volume of fluids greater than or equal to 10 l was the only independent risk factor (adjusted odds ratio = 10.49, 95% CI, 2.34-47.02; P = 0.002). No significant differences were documented in relation to the behaviour of the serum markers. (C) 2001 Elsevier Science Ltd. Al rights reserved.