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首页> 外文期刊>Journal of Clinical Medicine Research >Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma
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Early Prediction and Outcome of Septic Encephalopathy in Acute Stroke Patients With Nosocomial Coma

机译：急性脑卒中院内昏迷患者感染性脑病的早期预测和结果

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Background: Septic encephalopathy (SE) is the most common acute encephalopathy in ICU; however, little attention has been focused on risk of SE in the course of acute stroke. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC).Methods: A retrospective cohort study was conducted in an ICU of the tertiary teaching hospital in China from January 2006 to December 2009. Ninety-four acute stroke patients with NC were grouped according to with or without SE. Risk factors for patients with SE were compared with those without SE by univariate and multivariate analysis.Results: Of 94 stroke patients with NC, 46 (49%) had NC with SE and 48 (51%) had NC without SE. The onset-to-NC time was significant later in stroke patients with SE than those without SE (P < 0.01). There was a significant difference in body temperature, heart rate, respiratory rate, white blood cell (WBC), systolic blood pressure (SBP), diastolic blood pressure (DBP), systemic inflammatory response syndrome (SIRS), acute respiratory failure, septic shock, hypernatremia, and sequential organ failure assessment (SOFA) score between the SE and non-SE group (P < 0.05). On a repeat head imaging, vasogenic edema (P = 0.023) and subcortical white matter lesions (P = 0.011) were significantly higher in patients with SE than those without SE, while hematoma growth (P = 0.000), infarction progress (P = 0.003), and recurrent subarachnoid hemorrhage (SAH) (P = 0.011) were significantly lower in patients with SE than those without SE. Patients with SE had higher adjusted rates of fever ≥ 39 °C (odds ratio (OR): 2.753; 95% confidence interval (CI): 1.116 - 6.794; P = 0.028) and SIRS ≥ 3 items (OR: 6.459; 95% CI: 2.050 - 20.351; P = 0.001). The 30-day mortality in stroke patients with SE was higher than those without SE (76.1% vs. 45.8%, P = 0.003).Conclusion: High fever and severe SIRS are two early predictors of stroke patients with SE, and survival rates were worse in stroke patients with SE than those without SE.J Clin Med Res. 2015;7(7):534-539doi: http://dx.doi.org/10.14740/jocmr2176w
机译：背景：败血症性脑病（SE）是ICU中最常见的急性脑病。但是，很少有注意力集中在急性中风过程中发生SE的风险上。我们的目的是调查卒中后医院昏迷（NC）患者SE的早期预测和结果。方法：回顾性队列研究于2006年1月至2009年12月在中国三级教学医院的ICU中进行。94急性卒中NC患者根据有无SE分组。通过单因素和多因素分析比较了SE患者和未SE患者的危险因素。结果：94例NC卒中患者中，有SE的NC患者为46（49％），无SE的患者为48（51％）。患有SE的中风患者比没有SE的中风患者起病至NC时间显着晚（P <0.01）。体温，心率，呼吸频率，白细胞（WBC），收缩压（SBP），舒张压（DBP），全身性炎症反应综合征（SIRS），急性呼吸衰竭，败血性休克存在显着差异SE和非SE组之间的血脂，高钠血症和顺序器官衰竭评估（SOFA）评分（P <0.05）。在重复的头部影像学检查中，SE患者的血管生成性水肿（P = 0.023）和皮层下白质病变（P = 0.011）显着高于没有SE的患者，而血肿增长（P = 0.000），梗塞进展（P = 0.003） ），SE患者的复发性蛛网膜下腔出血（SAH）（P = 0.011）显着低于没有SE的患者。 SE患者的调整后发烧率≥39°C（比值（OR）：2.753; 95％置信区间（CI）：1.116-6.794; P = 0.028）和SIRS≥3（OR：6.459; 95％ CI：2.050-20.351; P ＝ 0.001）。伴有SE的中风患者的30天死亡率高于未伴SE的中风患者（76.1％vs.45.8％，P = 0.003）。结论：高热和严重SIRS是SE的中风患者的两个早期预测指标，生存率是患有SE的中风患者比没有SE的患者更为严重。JClin Med Res。 2015; 7（7）：534-539doi：http://dx.doi.org/10.14740/jocmr2176w

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