Effect Of Low-dose Glucocorticoid On Prognosis Of Patients With Septic Shock

Objective: To investigate the effect of low-dose glucocorticoids on mortality and complications in patients with septic shock.Methods: A retrospective analysis of 203 cases of septic shock in the emergency intensive care unit(EICU)and the intensive care unit(MICU)of the First Affiliated Hospital of Guangxi Medical University from January 1,2015 to October 1,1818,A total of 82 cases were included in the standard.The general condition of the patient,the underlying disease,the source of the infection were collected,and the mean arterial pressure(MAP),heart rate(HR),blood lactate(Lac),and white blood cells at admission were recorded at the time of admission and at 12,24,and 48 hours of treatment.WBC),neutrophil absolute value(NEU),neutrophil percentage(N%),high-sensitivity C-reactive protein(CRP),procalcitonin(PCT)and other indicators;observed mortality,double Complications such as infection,hyperglycemia,gastrointestinal bleeding and hypernatremia.The measurement data were analyzed by t test or rank sum test,and the count data were analyzed by chi-square test.Logistic regression analysis was performed on the 28-day mortality of the patients.Results: 1.The age,sex,underlying disease,primary infection site,ApacheII score at admission,Lac,MAP,WBC,N%,PLT,PCT,CRP,Cr were not found in the hormone group and the control group.Statistical significance(P>0.05).2.the hormone group,the control group of patients with 7-day mortality,28-day mortality,90-day mortality and double infection,hyperglycemia,gastrointestinal bleeding,hypernatremia and other complications were not statistically significant(P >0.05).3.One-way logistic regression analysis showed that the 28-day mortality rate of patients showed Apache II score at admission(OR=1.077,95% CI1.009~1.149,P=0.026),lactic acid(OR=1.382,95% CI 1.140~1.674,P =0.001),neutrophil percentage(OR=0.001,95% CI 0.000~0.172,P=0.010),platelets(OR=0.993,95% CI 0.989~0.989,P=0.005)were 28 days for septic shock patients Factors associated with mortality.4.Multivariate logistic regression analysis showed that 28-day mortality showed that lactic acid(OR=0.001,95% CI 0.000~0.172,P=0.010)was an independent risk factor for 28-day mortality in patients with septic shock.Conclusion: Low-dose glucocorticoids had no significant effect on the prognosis of patients with septic shock,and elevated lactic acid at admission was an independent risk factor for 28-day mortality in patients with septic shock.