Retrospective Study Of Circulating Perfusion Parameters And Prognosis Of Blood Stasis Syndrome Based On Sepsis 3.0

ObjectiveTo investigate the differences in patients between Sepsis 3.0 and Sepsis 1.0 with blood stasis syndrome for the outcomes of the severity of sepsis,the perfusion parameters,clinical interventions,and hospitalization endpoints.An attempt to provide some medical evidences for clinical treatment and prognosis in sepsis was made.MethodsThis study is a retrospective cohort study.Patients who were admitted to the Department of Intensive Care Unit,Fangcun Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2015 to December 2017 were enrolled in the study.According to the diagnostic criteria of sepsis 3.0 and 1.0,they were classified as SOFA group and SIRS group,and according to the TCM symptom standard,the components were divided into two subgroups of blood stasis syndrome and non-blood stasis syndrome.Differences of clinical scores,circulating perfusion parameters,clinical interventions and etc.were compared before the inclusion(TOh),at the time of inclusion(T24h),and after the inclusion(referral/discharge/death)between groups and within-group of blood stasis syndrome.Treatment endpoints and health economics were used to evaluate final clinical outcomes.Resu!tsA total of 112 patients were enrolled in the study,with 56 patients in each group.At baseline,a significant difference in SAP between the two overall groups was showed(P<0.05),while within-group of blood stasis was balanced.Before the inclusion,compared to the blood stasis group of SIRS group,it was more severe in SOFA group of the disease after assessment of APACHE ? score and the oxygenation index(P<0.05),and the APTT was also relatively longer(P<0.05).After 24hs,the blood stasis intergroup in the SOFA group showed a difference in oxygenation index(P<0.05).There were a statistical difference of SAP,MAP and ?APACHE? between blood stasis group of SOFA and SIRS groups(P<0.05)after included.The amount of colloidal fluid,blood transfusion rate,and mechanical ventilation rate in the SOFA group were more aggressive than those in the SIRS group(P<0.05).The statistical differences between the overall groups were similar to between-groups of blood stasis in these three time periods.Logistic regression analysis showed that differentiation of blood stasis syndrome,oxygenation index and APACHE ?scores may have an impact on ICU hospital mortality(P<0.05).The ROC curve results suggest that the APACHE ? score is more sensitive to the risk assessment of ICU hospital mortality(sensitivity=1.00,specificity=0.69,AUC=0.86,P<0.05).Compared to the intergroup of SIRS group,patients within the blood stasis group of SOFA group had higher ICU hospital mortality(0 vs.33.33%,P<0.05)and total encounter costs(3.17 vs.4.72,P<0.05),and there was no difference in length stayed in hospital or ICU,the overall outcomes between two groups was basically same as the intergroup.ConclusionPatients diagnosed as sepsis with criteria of sepsis 3.0 are more severe than those in sepsis 1.0,and there is no difference in the circulating perfusion parameters between two groups.The amount of colloidal fluid,the use of blood transfusion and mechanical ventilation in the former group are more aggressive than the latter.The overall data comparisons within the two groups of blood stasis syndrome are similar to between-groups.As one of the independent risk factors,oxygenation index,APACHE ? score,blood stasis syndrome differentiation may be affecting the prognosis of patients under two diagnostic criteria.