Clinical Features And Risk Factors Associated With The Death Of Septic Patients

Objective: To investigate the incidence of sepsis in adults received in ICU, and its demographic characteristics, feature and outcome of infection, and analyze affecting factors relevant to death, screen effective warning indicators of sepsis which are beneficial to its early diagnosis, risk stratification, and thereby improve the condition of sepsis treatment.Methods:By screening sepsis patients received in the ICU of the third hospital of Hebei medical university between 2012 and 2014, retrospective analysis and case-control study method were applied, and the clinical features of sepsis was analyzed. At the same time, the single factor correlation analysis and logistic regression analysis were applied to the above factors, to identify the independent risk factors of death in sepsis patients.Results:1 There are 370 sepsis cases in the 1107 patients received in ICU of our hospital between 2012 to 2014, and the incidence rate is 33.4%; the median age is 66, and the quartile is 58-77. The male occupies 262 cases(70.8%) and the female is 108 cases, suggesting male is more likely to be attacked than female. There are 210 cases of severe sepsis and septic shock, representing 56.8%.2 Most patients were transferred to ICU due to respiratory system disease, and the earlier of transferring to ICU, the higher the motility rate will be. The focus of infection concentrates in lung infection, representing 64.3% and the pathogenic microorganism are mainly G-bacterium(62.7%).3 223 out of 370 cases(60.3%) used antibiotics one hour after the confirm diagnosis, 272 cases(73.5%) used mechanical ventilation treatment, and 176 cases(47.6%) used continuous blood purification treatment。4 172 patients died in these 370 sepsis cases, which makes the fatality rate 46.5%. The age, blood lactic acid, serum creatinine, and other critical disease evaluation grades of death group were higher than the survival group, and the difference was statistically significant(P<0.01). The cancer, heart failure, hypohepatia in death group were higher than survival group, and the difference was statistically significant(P<0.05). patients applying the mechanical ventilation and blood purification in death group were higher than survival group, and the difference was statistically significant(P<0.01). Septic shock, ALI, ARDS, MODS cases in death group were higher than survival group, and the difference was statistically significant(P<0.05).5 Sepsis single factor analysis shows the age, APACHE II grades, cancer septic shock, MODS, time of entering ICU effected the survival of patients(P<0.05). Multifactor regression analysis shows the fatality rate of sepsis has a positive correlation with age, APACHE II grades, septic shock and MODS(P<0.05).Conclusion:The incidence rate of sepsis in ICU is high, male is more likely to be suffered from sepsis than female. patients of high ages, suffering from tumour, heart failure, hypohepatia should pay more attention of sepsis. Respiratory tract is the most common infection site, and pneumonia occupies the first place of sepsis, bacteria is the main pathogenic bacteria, usually appeared as G-bacteria. Age, APACHE II grades, septic shock, MODS is the high risk factor which result to the death of sepsis. Analyze from the perspective of time: transferring to ICU soon after confirmation of sepsis, and intervention treatment of sepsis at the early stage, will effectively improve the outcome of the sepsis patients.