Aggregate Evaluable Organ Dysfunction Predicts In-Hospital Mortality from Sepsis in Uganda
Aggregate Evaluable Organ Dysfunction Predicts In-Hospital Mortality from Sepsis in Uganda
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DOI：
10.4269/ajtmh.2011.10-0692
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发表时间：
2011-10-01
影响因子：
3.3
通讯作者：
Moore, Christopher C.
中科院分区：
文献类型：
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作者：
Ssekitoleko, Richard;Pinkerton, Relana;Moore, Christopher C.
我们在乌干达一家地区转诊医院评估了150例非手术性脓毒症患者的脓毒症严重程度与院内死亡率之间的关系。5/52例（9.6%）脓毒症患者、24/71例（33.8%）严重脓毒症患者和16/27例（59.3%）脓毒性休克患者发生院内死亡。在多因素分析中，严重脓毒症的识别（校正风险比[AHR] = 2.9，95%置信区间[CI] = 1.0-8.2，P = 0.04），脓毒性休克（AHR = 5.7，95% CI = 1.6-20.3，P = 0.007），三个或三个以上器官功能障碍（AHR = 2.9，95% CI = 1.1-7.3，P = 0.03）增加了住院死亡的风险。将聚集器官功能障碍添加到包括脓毒症类别的多变量方程中，在统计学上显著改善了模型，但相反则没有。死亡率的预测指标易于测量，可用于对资源有限的危重患者进行风险分层。
We evaluated the association between severity of sepsis and in-hospital mortality in 150 patients with nonsurgical sepsis at a regional referral hospital in Uganda. In-hospital mortality occurred in 5 of 52 (9.6%) patients with sepsis, 24 of 71 (33.8%) patients with severe sepsis, and 16 of 27 (59.3%) patients with septic shock. In the multivariate analysis, the identification of severe sepsis (adjusted hazard ratio [AHR] = 2.9, 95% confidence interval [CI] = 1.0-8.2, P = 0.04), septic shock (AHR = 5.7,95% CI = 1.6-20.3, P = 0.007), and dysfunction of three or more organs (AHR = 2.9, 95% CI = 1.1-7.3, P = 0.03) increased the risk of in-hospital mortality. Adding aggregate organ dysfunction to the multivariate equation that included the sepsis category statistically significantly improved the model, but the opposite did not. Predictors of mortality were easily measurable and could be used to risk stratify critically ill patients in resource-constrained settings.