Risk Factors for Sepsis Based on Sepsis-3 Criteria after Orthotopic Liver Transplantation.
Risk Factors for Sepsis Based on Sepsis-3 Criteria after Orthotopic Liver Transplantation.
复制标题
基于脓毒症 3 标准的原位肝移植后脓毒症的危险因素。
DOI：
10.1155/2018/8703172
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发表时间：
2018
影响因子：
4.6
通讯作者：
Hei Z
中科院分区：
文献类型：
--
作者：
Wang Y;Gu Y;Huang F;Liu D;Zhang Z;Zhou N;Liang J;Lu C;Yuan D;Hei Z
脓毒症是实体器官移植手术的常见并发症，特别是可以影响原位肝移植（奥尔特）的预后。这项回顾性研究确定了奥尔特后脓毒症的术前、术中和术后风险因素，参考了2016年第三次脓毒症和脓毒性休克国际共识定义（脓毒症-3）。分析了脓毒症阳性组（n = 85）和脓毒症阴性组（n = 41）的术前、围术期和术后临床数据，以寻找OLT相关脓毒症的潜在危险因素。脓毒症阳性组透析率（49.4%）、机械通气时间（1.5d）、住院费用（41万元）、生存率（68.5%）均显著高于脓毒症阴性组（4.8%、1d、30万元、73.1%）。多变量logistic分析确定以下因素为OLT相关脓毒症的危险因素：术前Child-Pugh C级（OR 10.43; 95% CI 2.081-52.292; P = 0.004），术前高钙血症（OR 6.372; 95%CI 1.693-23.98; P = 0.006）和围手术期酸中毒（OR 6.364; 95%CI 1.196-33.869; P = 0.030）。术前Child-Pugh C级、术前高钙血症或围手术期酸中毒的患者在奥尔特后发生脓毒症的风险较高。当任何这些问题发生时，应计划及时的脓毒症管理。
Sepsis is a common complication of solid organ transplant procedures and, in particular, can affect the prognosis of orthotopic liver transplantation (OLT). This retrospective study determined the pre-, peri-, and postoperative risk factors for sepsis after OLT, using as reference the 2016 Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Pre-, peri-, and postoperative clinical data of the sepsis-positive (n = 85) and sepsis-negative (n = 41) groups were analyzed for potential risk factors of OLT-related sepsis. The sepsis-positive patients had a significantly higher rate of dialysis (49.4%), longer time under mechanical ventilation (1.5 d), higher hospitalization costs (0.41 million RMB), and worse survival rate (68.5%), compared with the sepsis-negative patients (4.8%, 1 d, 0.30 million RMB, and 73.1%, resp.). The multivariate logistic analysis identified the following as risk factors for OLT-related sepsis: preoperative Child-Pugh grade C (OR 10.43; 95% CI 2.081–52.292; P = 0.004), preoperative hypercalcemia (OR 6.372; 95% CI 1.693–23.98; P = 0.006), and perioperative acidosis (OR 6.364; 95% CI 1.196–33.869; P = 0.030). Patients with preoperative Child-Pugh grade C, preoperative hypercalcemia, or perioperative acidosis are at higher risk for developing sepsis after OLT. When any of these problems occur, timely sepsis management should be planned.
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影响因子：
13.2
作者：
Kraut, Jeffrey A.;Madias, Nicolaos E.
通讯作者：
Madias, Nicolaos E.
影响因子：
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Burroughs, Andrew
影响因子：
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作者：
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通讯作者：
Blecher, S
影响因子：
0.9
作者：
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Kóbori, L