JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (10): 80-84.doi: 10.6040/j.issn.1671-7554.0.2015.957

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Prognostic analysis of patients with severe sepsis and septic shock

LIU Xiao1, LIU Zhiguang1, FAN Zhisong2, WANG Yuan1, YANG Xingxiao1, KONG Jieyu1, CHEN Junzhuo1, LIU Junxia3   

  1. 1. Department of Hospital Infection Management;
    2. Department of Medical Oncology;
    3. Department of Infectious Diseases, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China
  • Received:2015-10-11 Online:2016-10-10 Published:2016-10-10

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Abstract: Objective To explore the prognostic factors for patients with severe sepsis and septic shock according to the survival periods. Methods Clinical data of 108 cases of severe sepsis and septic shock treated during Jan. 2013 and Dec. 2014 were retrospectively studied. The independent risk factors of death was analyzed with Cox porportional hazard models. Results The overall mortality was 53.7%, and the mortality at days 0-29, 30-89, and 90-365 was 27.8%, 24.4% and 15.3%, respectively. Factors significantly associated with mortality included APACHE-Ⅱscore(HR=1.105, 95%CI: 1.066-1.146), Charlson Comorbidities Index(CCI)(HR=1.390, 95%CI: 1.210-1.596)and procalcitonin changes(△PCT)(HR=0.996, 95%CI: 0.995-0.997). Results of stratified analysis according to different survival periods indicated that, APACHE-Ⅱscore(HR=1.104, 95%CI: 1.052-1.158), CCI(HR=1.462, 95%CI: 1.204-1.775), △PCT(HR=0.992, 95%CI: 0.989-0.995), and days of ICU-stay(HR=0.893, 95%CI: 0.841-0.949)were the prognostic factors for patients who survived for less than 30 days; risk factors associated with mortality included APACHE-Ⅱscore(HR=1.102, 95%CI: 1.026-1.183)and △PCT(HR=0.996, 95%CI: 0.994-0.998)for patients who survived for 30 d-89 d; for patients survived for 90 d-365 d, CCI(HR=1.689, 95%CI: 1.065-2.679)was the only prognostic factor. Conclusions APACHE-Ⅱscore, CCI and △PCT are the independent 山 东 大 学 学 报 (医 学 版)54卷10期 -刘晓,等.严重脓毒症与脓毒性休克患者预后分析 \=-prognostic factors for patients with severe sepsis and septic shock, while there were slight differences among different survival periods. It is necessary to develop a multicenter large-scale prospective cohort study for further confirmation.

Key words: Stratified analysis, Severe sepsis, Septic shock, Prognosis

CLC Number: 

  • R631
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