Effect of early bundle therapy on prognosis of patients with sepsis and septic shock
10.3760/cma.j.issn.1671-0282.2019.02.008
- VernacularTitle:早期集束化治疗对脓毒症及脓毒性休克患者预后的影响
- Author:
Bing JI
1
;
Jianliang ZHU
;
Limei MA
;
Huiqin YUAN
;
Xingyu JIA
;
Lijun LIU
;
Jianjun ZHU
Author Information
1. 苏州大学附属第二医院急诊科 215000
- Keywords:
Sepsis/septic shock;
Sepsis bundles;
Lactate clearance;
Sequential organ failure score;
Fluid resuscitation
- From:
Chinese Journal of Emergency Medicine
2019;28(2):170-174
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of early bundle therapy on prognosis of patients with sepsis/septic shock and analyze the risk factors for death.Methods A retrospective cohort study was conducted to select patients with sepsis/septic shock at the Second Soochow University Hospital betweenJanuary 1,2016,and December 31,2016.Data pertaining to demographic variables,compliance rate of bundle therapy,and incidence of organ failure were collected.Patients were categorized into the nonsurvivor or survivor groups based on 28-day mortality.Logistic regression analysis was used to identify risk factors for 28-day mortality.Results Totally 118 sepsis/septic shock patients were included in the analysis;28-day mortality was 32.2％.Compared to the survivor group,patients in the non-survivor group were more likely to have chronic heart dysfunction and cerebrovascular disease,lower lactate clearance,lower 6-h compliance rate of bundle therapy and higher incidence of failure of one or ＞2 organs.Age,leukocyte,blood urea nitrogen,creatinine,brain natriuretic peptide,sequential organ failure score and acute physiological and chronic health scores Ⅱ on admission,and lactate after bundle therapy were higher than that of the survivor group.Logistical regression analysis showed that age ≥ 75 years [odds ratio (OR)1.012],6-h lactate clearance ＜30％ (OR=1.122),chronic heart failure (OR=1.741),failure of ＞2 organs (OR=1.769),and 6-h compliance rate of bundle therapy (OR=1.958) were independent risk factors for 28-day mortality.Conclusions Patients with sepsis/septic shock need early diagnosis and resuscitation to improve the compliance rate of bundle therapy and reduce the mortality.
