Compliance Investigations And Prognosis Of Sepsis Bundle In Patients With Septic Shock

Objective1.Through the analysis of the clinical data was retrospectively, survey of Ningxia Medical University General Hospital ICU in patients with septic shock cluster treatment compliance and mortality rate.2. Analysis of effects of difference on prognosis of sepsis bundle compliance.3.Clear as soon as possible to complete sepsis bundle effect on prognosis in patients with septic shock.MethodsThe collection of General Hospital of Ningxia Medical University ICU 2009.1.1-2013.12.31 in 111 cases of patients with septic shock and clinical data, were investigated retrospectively. First January 2009-December 2013 overall case fatality rate of septic shock and the yearly fatality.Second, All subjects were divided into survival and death,Comparison of the two groups in age,gender,acute physiology and chronic health evaluation II(APACHE II), systemic infection related organ failure score(SOFA), Glasgow Coma Scale(GCS), history, sites of infection, diagnosis and treatment of invasive surgery, number of organ failure and other general information. By chi square test to clear the statistics difference.By 2008 serious sepsis and septic shock treatment guidelines of bundle therapy beam as the standard, Investigation and treatment of the individual treatment of cluster strategies and goals,Based on the incorporation of 28 d in patients with septic shock survival, While investigating two groups of patients were sepsis bundle compliance of each single cluster strategies and goals.Through the analysis of the treatment beam single standard difference different prognosis in patients with chi square test, The final clear ahead of time to complete the cluster effect of treatment on prognosis of the patients.ResultsIn 2009 January-2013 year in December included 5 years of Ningxia Medical University, ICU diagnosis of septic shock in 111 patients the overall mortality rate for 28 days was 67.6%.In 5 years the mortality rate showed no significant difference(p=0.112).On the prognosis in patients with different clinical data((Age, sex, SOFA score, APACHE II score, parts of the surgery, infection, invasive diagnosis and treatment, the number of organ failure)analysis and statistics. Results showed different prognosis of APACHE II scores, SOFA scores between patients, the number of organ failure has statistical significance(p<0.05).Display 6h cluster treatment compliance rate was more than 66% in the treatment of 111 cases of patients were included in the investigation of the 2008 international standard of severe sepsis and septic shock treatment guide bundle, The broad-spectrum antibiotics in 1H treatment started within the standard completely, The standard rate of use of small doses of hormones is only 28.83%. survival Group’s compliance rate is higher than the death rate. Difference between the two groups was statistically significant(P<0.05).based on different project compliance with statistical significance(P<0.05).Found in the impact analysis as soon as possible to achieve the bundle treatment on prognosis of the patients in the project, "3h within the lactic acid test" and the "blood culture" completion of the survived patients was significantly more than 3-6h "lactic acid test" and "collecting virological specimens" number of survivors, the difference was statistically significant(p<0.05)Conclusion1. January 2009 to December 2013 Ningxia Medical University General Hospital ICU patients with septic shock 67.6% 28 d the overall case-fatality rate;2. Through the SOFA and APACHE score II score and organ failure number can be used to evaluate the prognosis of the patients;3.General Hospital of Ningxia Medical University, ICU treatment compliance among the items larger differences in septic shock cluster. Individual cluster treatment compliance related with the prognosis of the patients, Improved cluster can reduce treatment compliance of patients with septic shock mortality;4. As soon as possible to complete the bundle treatment strategy may guide some more reasonable clinical treatment, reduce the mortality rate of septic shock.