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首页> 外文期刊>Journal of Clinical Medicine Research >Sepsis in the Neurologic Intensive Care Unit: Epidemiology and Outcome
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Sepsis in the Neurologic Intensive Care Unit: Epidemiology and Outcome

机译：神经重症监护病房的败血症：流行病学和结果

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Background: Sepsis is a major contributor to mortality in patients admitted to a general intensive care unit (ICU). Early recognition and treatment of sepsis is key in improving outcomes. The epidemiology and outcome of sepsis in neurologic ICU (NeuroICU) has not been evaluated.Methods: We retrospectively identified all patients admitted to our 16-bed NeuroICU between June 2009 and December 2013 using the acute physiologic and chronic health evaluation (APACHE) outcomes database. We excluded patients admitted with an infection, such as meningitis, encephalitis, brain or spinal abscess, or with any other infection. We compared NeuroICU patients who did to NeuroICU patients who did not develop sepsis after ICU admission. The diagnosis of sepsis was based on the SCCM/ACCP consensus conference definition.Results: There were a total of 2,025 patients, out of which 29 patients (1.4%) developed sepsis. Patients who developed sepsis had a trend towards older age (67 ± 13 vs. 61 ± 11 years, P = 0.07), a trend towards more male gender (69.0% vs. 51.5%, P = 0.07), significantly higher APACHE III scores (58 ± 17 vs. 43 ± 21, P = 0.0001), and significantly higher acute physiologic scores (APS) (43 ± 16 vs. 32 ± 18, P = 0.001) than patients who did not develop sepsis. Patients who developed sepsis had higher ICU mortality (41.4% vs. 5.1%, odds ratio (OR) = 13.1; 95% confidence interval (CI), 6.1 - 28.2, P < 0.0001), and higher hospital mortality (44.8% vs. 8.2%, OR = 9.0; 95% CI, 4.3 - 19.0, P < 0.0001).Conclusions: Sepsis developed in 1.4% of patients admitted to a NeuroICU. Predictors of sepsis development were comorbidities and worsening acute physiologic variables. Patients who developed sepsis had significantly higher mortality. Vigilance to development of sepsis in NeuroICU is paramount, especially in this era when early recognition and intervention of sepsis significantly improves outcomes.J Clin Med Res. 2015;7(1):18-20doi: http://dx.doi.org/10.14740/jocmr1935w
机译：背景：脓毒症是导致进入普通重症监护病房（ICU）的患者死亡率的主要因素。败血症的早期识别和治疗是改善预后的关键。方法：我们使用急性生理和慢性健康评估（APACHE）结果数据库回顾性分析了2009年6月至2013年12月间16床NeuroICU入院的所有患者。 。我们排除了因感染如脑膜炎，脑炎，脑或脊髓脓肿或任何其他感染而入院的患者。我们将接受ICU的NeuroICU患者与未发生败血症的NeuroICU患者进行了比较。结果：共有2025例患者发生脓毒症，其中29例（1.4％）患有脓毒症。发生败血症的患者的年龄趋势有所增加（67±13岁，相对于61±11岁，P = 0.07），男性倾向较高的趋势（69.0％，相对于51.5％，P = 0.07），APACHE III评分明显更高（58±17 vs. 43±21，P = 0.0001），并且急性生理分数（APS）明显高于未发生败血症的患者（43±16 vs. 32±18，P = 0.001）。发生败血症的患者的ICU死亡率较高（41.4％vs.5.1％，比值比（OR）= 13.1; 95％的置信区间（CI），6.1-28.2，P <0.0001）和较高的医院死亡率（44.8％vs. 8.2％，OR = 9.0; 95％CI，4.3-19.0，P <0.0001）。结论：接受NeuroICU治疗的患者中有1.4％发生败血症。败血症发生的预测因素是合并症和急性生理变量的恶化。发生败血症的患者死亡率明显更高。对NeuroICU脓毒症的发展保持警惕是至关重要的，尤其是在这个时代，尽早识别和干预败血症可显着改善结局。JClin Med Res。 2015; 7（1）：18-20doi：http://dx.doi.org/10.14740/jocmr1935w

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