Risk factors related to death in patients with tuberculosis complicated with sepsis in an intensive care unit
10.3760/cma.j.cn311365-20230428-00132
- VernacularTitle:重症监护病房结核病合并脓毒症患者死亡相关的危险因素分析
- Author:
Kunping CUI
1
;
Yi MAO
;
Lang BAI
Author Information
1. 四川大学华西医院感染性疾病中心，成都 610041
- Keywords:
Tuberculosis;
Sepsis;
Death;
Intensive care units;
Risk factors
- From:
Chinese Journal of Infectious Diseases
2023;41(10):640-646
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors related to death in patients with tuberculosis complicated with sepsis in an intensive care unit, in order to provide reference for the clinical treatment of patients with tuberculosis complicated with sepsis.Methods:A retrospective case-control study was conducted to collect the general clinical data of 384 patients with tuberculosis complicated with sepsis in intensive care unit of Public Health Clinical Center of Chengdu from March 2020 to November 2022. Multivariate logistic regression model was used to analyze independent risk factors for death in patients with tuberculosis complicated with sepsis.Results:Among 384 patients with tuberculosis complicated with sepsis, the 28-day mortality rate was 43.2%(166/384). Multivariate logistic regression analysis showed that age ≥60 years old (odds ratio ( OR)=1.924, 95% confidence interval ( CI) 1.033 to 3.585, P=0.039), body mass index (BMI) <18.5 kg/m 2 ( OR=4.496, 95% CI 2.242 to 9.016, P<0.001), acute physiology and chronic health evaluation (APACHE) Ⅱ ≥20 points ( OR=2.133, 95% CI 1.093 to 4.162, P=0.026), blood urea nitrogen-to-albumin ratio>5.945 mg/g ( OR=20.886, 95% CI 10.883 to 40.084, P<0.001) and septic shock ( OR=6.137, 95% CI 2.852 to 13.209, P<0.001) were independent risk factors for death in patients with tuberculosis complicated with sepsis in intensive care unit. Conclusions:Age≥60 years old, BMI<18.5 kg/m 2, APACHE Ⅱ≥20 points, blood urea nitrogen-to-albumin ratio>5.945 mg/g and septic shock are independent risk factors for the death in patients with tuberculosis complicated with sepsis. Early attention should be paid to these patients and cluster therapy should be started as soon as possible in order to shorten the disease process, and to improve the prognosis and reduce mortality.
