Intensive Medicine Adult Ritically Ill Patients Died Ariations Retrospective Analysis

Background:Patients with severe medicine case fatality rate is significantly higher than the current situation of the other disciplines is an indisputable fact.Due to the various regions,different hospitals,and even the same hospital medical unit of critically ill patients with disease and illness severity,the case fatality rate will be significantly different.How to reduce the mortality of severe medicine still faces big challenges.Induced by the infection of severe sepsis and septic shock is the important cause of death in critically ill patients.Early identification and correct diagnosis and timely treatment can reduce mortality in patients with severe sepsis.Objective:A retrospective analysis of intensive medicine ariations adult critically ill patients died,the characteristics of understanding what is disease of high incidence and high mortality.The incidence of severe sepsis and septic shock and how much is the missed diagnosis.Exploration is helpful to improve the medical quality,improve the clinical effect of treatment strategies and treatment methods.Methods:To collect 2014 January 1 to December 31,2014 in the first affiliated hospital of Guangxi Medical University medical ICU,surgical ICU,west hospital information of all cases of patients in ICU.Inclusion criteria included(1)older than 18 patients;(2)emergency or outpatient service directly at patients;(3)common ward in a critical condition to patients;(4)monitoring of patients after surgery recovery.From the Angle of two different statistical analysis was carried out on the selected cases.First of all,conventional disease classification will be included in the patients were divided into surgical critically ill patients(i.e.,patients with trauma,burns and surgery related)and college of critically ill patients(except surgical critically ill patients)for the rest of the two categories,and then further subdivided according to system diseases,and statistics of surgical critically ill disease,internal medicine of critically ill disease and their corresponding disease death,determine which is high mortality rate and high incidence of disease.Second,according to whether patients with infections will be divided into two categories:infectious and noninfectious diseases.In 2012,according to international guidelines of diagnosis and treatment of severe sepsis and septic shock,in patients with infectious diseases statistics in accordance with severe sepsis and septic shock patients with diagnostic criteria of the number of cases,to conform to the diagnostic standard and no patients were defined as patients with diagnosis.But(including complications)contain the disease diagnosis"infected" or "severe infection" and similar expressions of cases as already in the diagnosis of severe sepsis.Results:(1)Patients eligible for in 1277,857(67.1%)male,420 female(32.9%),average age(56.0 ±16.7),the total death toll of 166(12.9%),among them,were higher in surgical critically ill is general surgery(52.0%)and neurosurgery(21.9%),is the highest mortality of acute(38.4%)and neurosurgery(21.9%).Medical critically ill is a higher incidence of respiratory system(33.3%),and the nervous system(19.0%),the highest mortality occurred was tumor(48.7%)and rheumatism system(29.8%).2.Among the 1277 patients,medical ICU,surgical ICU and hospital ICU west into the number of 593(46.4%),respectively,316(24.7%)and 368(28.8%),the death toll of 63(10.62%)respectively,45(14.24%)and 58(15.76%).3.Three different disease:ICU medical ICU admission rate highest disease is general surgery(23.1%)and respiratory medicine(27.2%),tumor mortality rates are the highest(46.7%)and rheumatism system(35.0%);Surgical ICU were the highest rate of disease is general surgery(18.0%)and respiratory medicine(18.0%),tumor mortality rates are the highest(56.3%)and burns(66.7%);West hospital ICU were the highest rate of disease is the circulatory system(25.0%),and the nervous system(17.7%),tumor mortality rates are the highest(37.5%)and neurosurgery(31.3%)?4.Among the 1277 patients,the number of primary or secondary infection of 1028(80.5%).In compliance with severe sepsis and septic shock diagnostic criteria of 290 people,22.7%of the total.In diagnosis of 127(43.8%)of them?Conclusion:In different medical units of intensive medicine ariations of critically ill patients with disease and death is different,each medical unit only adopt the corresponding strategy according to specific circumstances and is focused on the priorities,can reduce the mortality of severe medicine;Infection induced by severe sepsis/septic shock are common in ICU,missed diagnosis could be affect the treatment effect,increasing the mortality of patients with an important factor that cannot be ignored,deserves more attention from clinical doctors.