Study Of Different Infection Sites,risk Factors And Clinical Prognosis Of Sepsis Associated Encephalopathy

Background and purposeSepsis associated encephalopathy(SAE)is one of the common encephalopathy in critical care medicine,with an incidence and mortality rate of up to 70%.At present,there is not much research on the risk factors for the occurrence and development of SAE,especially those related to the site of infection,and the results of various studies are not the same.This study aims to investigate the risk factors associated with SAE and its adverse prognosis by collecting relevant data from patients with sepsis,and to analyze the incidence of SAE in patients with sepsis at different infection sites.MethodsThis study is a single-center,retrospective study of the clinical data of sepsis patients(n=130)admitted in the Department of Critical Medicine of Zhengzhou People’s Hospital from February 2015 to October 2022.To analyze the risk factors related to SAE and its adverse prognosis,and to explore the incidence of SAE in different infection sites.ResultsSAE incidence rate and risk factor analysis:The incidence rate of SAE is 49.2%.Through single factor analysis,there were statistical differences between SAE group and non-SAE group in infection sites,SOFA score,APACHE Ⅱ score,PCT,CRP,SCR,etc.(P<0.05).Six indicators with differences in univariate analysis were included in the logistic multivariate analysis.The results showed that APACHE score≥20 points and GCS score≤8 points were independent risk factors for sepsis associated encephalopathy in patients with sepsis(P<0.05).SAE clinical prognosis analysis:In this study,the total number of deaths of patients was 66,and the overall mortality rate was 50.8%.The mortality rate of SAE group was significantly higher than that of non-SAE group,and the difference between groups was statistically significant(P<0.05).The patients in the SAE group were divided into survival group and death group according to their clinical outcomes.After univariate analysis,the SOFA score,APACHE Ⅱ score,GCS score and SCR in the death group were significantly higher than those in the survival group,and the difference between the groups was statistically significant(P<0.05).Four indicators with differences in univariate analysis were included in the logistic multivariate analysis,which showed that APACHE Ⅱ score and SCR had statistical significance in evaluating the prognosis of patients with sepsis associated encephalopathy(P<0.05).Analysis of infection sites and etiology:The proportion of gastrointestinal tract infection in SAE group was significantly higher than that in non-SAE group,and the difference between groups was statistically significant(P<0.05).The detection rate of Pseudomonas aeruginosa and Enterococcus in the SAE group was significantly higher than that in the non-SAE group,and the difference between the groups was statistically significant(P<0.05).ConclusionsThe incidence rate of sepsis related encephalopathy is high,and the mortality of sepsis related encephalopathy is significantly higher than that of non sepsis related encephalopathy.Clinical workers need to pay attention to early diagnosis and active treatment to reduce the mortality.Sepsis patients with APACHE Ⅱ score≥ 20 on the first day of admission and GCS score ≤8 are more likely to develop SAE.The higher the APACHE Ⅱ score and Scr on the first day of admission for SAE patients,the greater the likelihood of clinical death.Dynamic assessment of patient condition,mental state,and Scr changes is beneficial for predicting the occurrence and prognosis of SAE.SAE is more likely to occur when the primary site of infection is the gastrointestinal tract.Patients with sepsis were more susceptible to SAE when they had Pseudomonas aeruginosa and enterococcus infection.Early identification of infection sites and pathogenic microorganisms is particularly important for the management of sepsis-associated encephalopathy.