Analysis Of Risk Factors Of Sepsis Liver Injury In Adult Intensive Care Unit

Sepsis has become the focus of medical staff’s attention and research due to its high morbidity,high mortality,and high medical costs.Sepsis can cause a variety of complications,including acute kidney injury,acute myocardial injury,liver injury,and multiple organ dysfunction syndrome(MODS),among which sepsis liver injury has become a difficult point in recent years.Because of its lack of clear definition and diagnostic criteria,it cannot be detected early,which has caused great obstacles to clinical medical workers in the correct diagnosis and treatment of this disease.This article compares the clinical data of patients with sepsis through retrospective analysis,including age,gender,presence or absence of hypoproteinemia,whether or not the hospitalization has surgery,whether it has diabetes,whether obesity,whether the main nutritional method is enteral nutrition,whether it is combined with septic shock,whether it is combined with a decrease in oxygenation index,etc,calculate the incidence of liver injury in patients with sepsis,explore the risk factors of the disease,and analyze the prognosis of patients.In order to improve clinical medical workers’ understanding of sepsis liver injury,increase the indications for early detection of sepsis,and provide some new methods and ideas for the prevention,diagnosis and treatment of sepsis liver injury.Objective:Observe and compare the age,gender,presence or absence of hypoproteinemia of patients with sepsis in the adult intensive care unit(ICU),whether there is surgery in the hospitalization,whether they have diabetes,whether they are obese,whether the main nutrition mode is for enteral nutrition,septic shock and other related observation indicators,analyze the risk factors,morbidity and prognosis of liver injury in patients with sepsis.In order to increase the importance of clinical medical workers on sepsis liver injury in the intensive care unit,we hope to provide some new methods and ideas for the prevention,diagnosis and treatment of patients with sepsis liver injury in the future.Methods:The clinical data of 224 sepsis patients who were hospitalized in the Department of Intensive Care Medicine of Baoding First Central Hospital between October 2017 and January 2020,who met the latest diagnostic criteria for sepsis,Sepsis-3,were selected.According to whether the patients meet the diagnostic criteria for liver injury and the patients’ 28-day survival status,sepsis patients are divided into groups.Collect the basic information of patients after admission,including: age,gender,main diagnosis,past history(hypertension,diabetes,coronary heart disease,chronic obstructive pulmonary disease(COPD),cerebrovascular disease,etc,primary infection site),Abdominal infection,surgical treatment in this hospitalization,body mass index(BMI),oxygenation index.Clinical monitoring indicators: Acute Physiology And Chronic Health Evaluation Ⅱ(APACHEII score)and Sequential Organ Failure Assessment,(SOFA)include all indicators.Hepatic injury evaluation indicators include:total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transpeptadase,(GGT),the above test results were recorded as the worst value after admission.Results:The study included a total of 224 patients with sepsis,including 82 patients with sepsis and liver injury,with an incidence rate of 36.61%.Of the54 patients who died,the mortality rate of patients in the sepsis liver injury group was 35.37%,which was significantly higher than the 17.61% of patients in the non-hepatic injury group.Univariate analysis suggests: age ≥60 years old,gender male,hypoproteinemia,surgery for this hospitalization,diabetes,obesity,non-enteral nutrition,septic shock,and oxygenation index Decrease,P<0.05.Multivariate analysis suggested that: age ≥60 years,gender male,combined with septic shock,a history of surgery in this hospitalization,combined with a decrease in oxygenation index,P<0.05.Conclusion:Patients with sepsis have a higher incidence and mortality of secondary liver injury,which seriously affects the prognosis of patients.Among them,age ≥ 60 years old,male sex,combined with septic shock,surgical treatment during this hospitalization,and decreased oxygenation index are independent risk factors for liver injury in patients with sepsis.