The spectrum of septic encephalopathy - Definitions, etiologies, and mortalities
The spectrum of septic encephalopathy - Definitions, etiologies, and mortalities
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DOI：
10.1001/jama.275.6.470
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发表时间：
1996-02-14
影响因子：
120.7
通讯作者：
Sprung, CL
中科院分区：
文献类型：
--
作者：
Eidelman, LA;Putterman, D;Sprung, CL
客观。-确定脓毒性脑病的严重程度是否与革兰氏阴性菌血症和死亡率相关，以及是否存在导致脓毒性脑病的单一或组合代谢紊乱。一个学术医疗中心的前瞻性病例系列。根据严重脓毒症的临床和实验室标准选择50名患者。标准包括体温、心率、呼吸频率、低血压和/或全身灌注不足的体征。代谢和实验室紊乱和器官衰竭的单一或组合，三种不同的方法来分级脓毒性脑病的严重程度，急性生理学和慢性健康评估II（APACHE II）评分，革兰氏阴性菌血症和感染，以及死亡率。根据格拉斯哥昏迷评分，脑病与死亡率增加相关;评分为15的患者死亡率为16%，13 - 14的患者死亡率为20%，9 - 12的患者死亡率为50%，3 - 8的患者死亡率为63%（P <0.05）。
Objective.-To determine whether the severity of septic encephalopathy is correlated with gram-negative bacteremia and mortality and whether there exists a single or combination of metabolic derangement(s) that cause septic encephalopathy.Design and Setting.-Prospective case series in an academic medical center.Patients.-Fifty patients selected according to clinical and laboratory criteria for severe sepsis. The criteria included temperature, heart rate, respiratory rate, and hypotension and/or signs of systemic hypoperfusion.Main Outcome Measures.-A single or combination of metabolic and laboratory derangements and organ failures, three different methods to grade the severity of septic encephalopathy, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, gram-negative bacteremia and infection, and mortality.Results.-Encephalopathy was associated with an increase in mortality when graded by the Glasgow Coma Score; a score of 15 had 16% mortality, 13 to 14 had 20%, 9 to 12 had 50%, and 3 to 8 had 63% mortality (P