An Analysis Of Survival Situation And Influence Factors For110Cases Of Hospitalized Patients With Sepsis

Object: To Learn survival of hospitalized patients with sepsis and explorethe related factors affecting the prognosis.Methods: Retrospective analysis of clinical data of110cases of sepsis inthe First Affiliated Hospital of Guangxi Medical University from January,2011to May,2013,using the Cox proportional hazard model to analyze the impact ofits survival.Results:(1) At the end point of the study,110patients,22cases died (20%),88cases survived (80%);1week survival rate was94%,1month survival ratewas79%, the2month survival rate was66%, with a median length of stay was20days.(2) The death of the patient’s age group, early lactate clearance rate islower than the survival of patients, the difference was statistically significant(P<0.05);(3) In the death group, combination lung injury, multiple organdysfunction syndrome was significantly more than the survival, the differenceswere statistically significant (P<0.05);(4) The number of purification in thedeath group was significantly more than that in the survival,the differences wasstatistically significant (P<0.05);(5) The death of the factors selected COXproportional hazard model multivariate regression equation of variable coefficient included the coefficient of variation of blood glucose (RR=1.069),early lactate clearance rate (RR=0.306), ALI/ARDS (RR=3.700), MODS (RR=4.923), hemoperfusion (RR=3.134);(5) Receiver operating characteristic curve(ROC) area under0.890, the equation determining the sensitivity of death was86.4%, specificity80.7%, the coincidence rate was78.94%, Kappa=0.425,P=0.001.Conclusions:(1) The mortality of sepsis is high. Whether combined withALI/ARDS and MODS, coefficient of variation of blood glucose, early lactateclearance rate and blood purification are the main factors influencing thehospitalization.(2) In judging the prognosis of patients with sepsis and guidingtreatment, early lactate clearance rate is more valuable than first admissionblood lactate concentration, coefficient of variation of blood glucose is morevalue than the average blood glucose.(3) The equation to the risk of death H (T,X)/h0(T)=Exp(-1.184early lactate clearance rate+1.308ALI/ARDS+1.594MODS+1.142hemopurification+0.067glucosevariability) have a certain value for prediction the prognosis of hospitalizedpatients,with a higher sensitivity (86.4%) and specificity (80.7%).