[1]林康昵.肿瘤重症监护室脓毒症患者预后影响因素分析[J].福建医药杂志,2024,46(05):14-17.[doi:10.20148/j.fmj.2024.05.004]
　LIN Kangni.Risk factors for sepsis patients with malignant tumor in intensive care unit[J].FUJIAN MEDICAL JOURNAL,2024,46(05):14-17.[doi:10.20148/j.fmj.2024.05.004]
点击复制

肿瘤重症监护室脓毒症患者预后影响因素分析()
分享到：

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期数:
2024年05期
页码:
14-17
栏目:
临床研究
出版日期:
2024-10-15

文章信息/Info

Title:
Risk factors for sepsis patients with malignant tumor in intensive care unit
文章编号:
1002-2600(2024)05-0014-04
作者:
林康昵
福建医科大学肿瘤临床医学院 福建省肿瘤医院重症医学科,福州 350014
Author(s):
LIN Kangni
Department of Critical Care Medicine, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian 350014, China
关键词:
脓毒症;  恶性肿瘤;  重症医学;  横断面研究
Keywords:
sepsis;  malignant tumor;  critical care medicine;  cross-sectional survey
分类号:
R73
DOI:
10.20148/j.fmj.2024.05.004
文献标志码:
B
摘要:
目的 分析肿瘤脓毒症患者的预后影响因素。方法 收集2021年1-6月在福建省肿瘤医院重症监护室(ICU)进行治疗的脓毒症患者的临床数据,对出现脓毒症的肿瘤患者的人口学资料、感染情况、ICU相关评分等进行分析,并通过Cox比例风险回归对90 d死亡率进行危险因素分析。结果 肿瘤脓毒症患者最常见的原发肿瘤为食管癌(19%),最常见的感染部位为肺部感染(69%),平均急性生理学和慢性健康评估(APACHE-Ⅱ)评分为13.0±3.9,中位序贯器官衰竭(SOFA)评分为5。共19名患者于入住ICU后90 d内死亡,90 d死亡率为32.8%。多因素分析结果提示,SOFA评分>8分为90 d死亡的危险因素[HR=10.504,95%CI:(2.383,46.298),P=0.002]。结论 SOFA评分>8分为肿瘤脓毒症患者预后的危险因素。
Abstract:
Objective To analyze the prognostic risk factors for sepsis in tumor patients.Methods Clinical data of sepsis patients with cancer who underwent treatment in our department from January 2021 to June 2021 were collected. Demographic data, infection status, ICU related scores, and other information were analyzed. Cox proportional hazards regression was used to analyze risk factors for 90-day mortality.Results A total of 58 patients were included in this study. The most common primary tumor was esophageal cancer(19%), and the most common site of infection was lung infection(69%). The average acute physiology and chronic health assessment(APACHE-II)score was 13.0±3.9, and the median sequential organ failure assessment(SOFA)score was 5. A total of 19 patients died within 90 days of admission to the ICU, with a 90-day mortality rate of 32.8%. The multivariate analysis indicate that a SOFA score greater than eight was an independent risk factor for 90-day mortality [HR=10.504, 95%CI:(2.383, 46.298), P=0.002].Conclusion SOFA score>8 is an independent prognostic risk factor.

参考文献/References:

[1] ANGUS D C, van der POLL T. Severe sepsis and septic shock[J]. The New England journal of medicine, 2013, 369(9):840-851.
[2] BAUER M, GERLACH H, VOGELMANN T, et al. Mortality in sepsis and septic shock in Europe, North America and Australia between 2009 and 2019- results from a systematic review and meta-analysis[J]. Critical Care(London, England), 2020, 24(1):239.
[3] HENSLEY M K, DONNELLY J P, CARLTON E F, et al. Epidemiology and outcomes of cancer-related versus non-cancer-related sepsis hospitalizations[J]. Critical Care Medicine, 2019, 47(10):1310-1316.
[4] NELMES E, EDWARDS L, JHANJI S, et al. Patients with cancer and sepsis trials: an unfair representation?[J]. Clinical Medicine(London, England), 2023, 23(6):635-636.
[5] SINGER M, DEUTSCHMAN C S, SEYMOUR C W, et al. The third international consensus definitions for sepsis and septic shock(Sepsis-3)[J]. Jama, 2016, 315(8):801-810.
[6] RANIERI V M, RUBENFELD G D, THOMPSON B T, et al. Acute respiratory distress syndrome: the Berlin Definition[J]. Jama, 2012, 307(23):2526-2533.
[7] QIU X, LEI Y P, ZHOU R X. SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis[J]. Expert Review of Anti-infective Therapy, 2023, 21(8):891-900.
[8] de GROOTH H J, GEENEN I L, GIRBES A R, et al. SOFA and mortality endpoints in randomized controlled trials: a systematic review and meta-regression analysis[J]. Critical Care(London, England), 2017, 21(1):38.
[9] 张洁, 佘丹阳, 冯丹, 等. SOFA评分及其动态变化比APACHEⅡ评分能更好反映脓毒症病情严重程度及预后[C]. 广州:中华医学会第五次全国重症医学大会, 2021.
[10] KOCHANEK M, SCHALK E, von BERGWELT-BAILDPN M, et al. Management of sepsis in neutropenic cancer patients: 2018 guidelines from the Infectious Diseases Working Party(AGIHO)and Intensive Care Working Party(iCHOP)of the German Society of Hematology and Medical Oncology(DGHO)[J]. Annals of Hematology, 2019, 98(5):1051-1069.
[11] DANAI P A, MOSS M, MANNINO D M, et al. The epidemiology of sepsis in patients with malignancy[J]. Chest, 2006, 129(6):1432-1440.
[12] WANG Y G, ZHOU J C, WU K S. High 28-day mortality in critically ill patients with sepsis and concomitant active cancer[J]. The Journal of International Medical Research, 2018, 46(12):5030-5039.
[13] LIU Y C, YAO Y, YU M M, et al. Frequency and mortality of sepsis and septic shock in China: a systematic review and meta-analysis[J]. BMC Infectious Diseases, 2022, 22(1):564.

相似文献/References:

[1]林兴盛,石松长.肝素治疗对严重脓毒症患者肺、肾功能的影响[J].福建医药杂志,2017,39(4):108.
[2]林树春 胡晓华 赖海春 林 勤.头颈部鳞状细胞癌患者体内免疫抑制性细胞因子与调节性T细胞的表达分析[J].福建医药杂志,2020,42(03):23.
　LIN Shuchun,HU Xiaohua,LAI Haichun,et al.Analysis of expression of immunosuppressive cytokines and regulatory T cells in patients with head and neck squamous cell carcinoma[J].FUJIAN MEDICAL JOURNAL,2020,42(05):23.
[3]叶 彦,任 飞 综述 黄慧恒 审校.血清NTx和ICTP在恶性肿瘤骨转移中的临床意义[J].福建医药杂志,2021,43(02):153.
[4]林爱芳,甘巧蓉,吴旭玮.血清程序性死亡蛋白1和高迁移率族蛋白1水平与脓毒症并发肝损伤的相关性研究[J].福建医药杂志,2024,46(01):8.[doi:10.20148/j.fmj.2024.01.003]
　LIN Aifang,GAN Qiaorong,WU Xuwei.Study on correlation of serum PD1 and HMGB1 with liver injury in patients with sepsis[J].FUJIAN MEDICAL JOURNAL,2024,46(05):8.[doi:10.20148/j.fmj.2024.01.003]
[5]刘加夫,张宏英,陈晓红,等.荧光ROSE在肺恶性肿瘤细胞学诊断中的应用分析[J].福建医药杂志,2024,46(04):6.[doi:10.20148/j.fmj.2024.04.002]
　LIU Jiafu,ZHANG Hongying,CHEN Xiaohong,et al.Analysis of fluorescence ROSE in cytological diagnosis of lung malignant tumors[J].FUJIAN MEDICAL JOURNAL,2024,46(05):6.[doi:10.20148/j.fmj.2024.04.002]
[6]陈伟,李燚,赖橼.脓毒症心肌抑制大鼠PTEN-PI3K-Akt信号通路的激活对心肌组织损伤及凋亡的影响[J].福建医药杂志,2024,46(07):72.[doi:10.20148/j.fmj.2024.07.023]

更新日期/Last Update: 2024-10-15