Analysis Of Factors Influencing The Prognosis Of Patients With Klebsiella Pneumoniae Induced Sepsis

Objective:To explore the factors influencing the prognosis of patients with Klebsiella pneumoniae induced sepsis,acute physiology and chronic health II score(APACHE ?)and sequential organ failure assessment(SOFA)were used to determine the severity and prognosis of such patients,so as to provide an effective treatment plan in the early stage Basis.Method:From January 2016 to September 2018,the clinical data of 321 patients with Klebsiella pneumoniae induced sepsis in the first hospital of Jilin University were analyzed retrospectively,including sex,age,basic diseases,length of stay before detection of Klebsiella pneumoniae,test indicators,length of stay in hospital,prognosis of patients,etc.Among 321 patients,196 were male(61.06%),125 were female(38.94%);the average age was(58.51 ± 13.77),the average length of stay was(16.83 ± 15.51)days,272 in the survival group(84.74%),and 49 in the death group(15.36%).The patients were divided into two groups: survival group and death group according to their 28 day improvement.SPSS 25.0 statistical software was used for data analysis,mean ± standard deviation(± s)was used for measurement data,and 2 tests were used for comparison of counting data.Logistic regression equation was used to analyze the factors influencing the prognosis of patients with Klebsiella pneumoniae sepsis,and the prognostic value of APACHE ? score and SOFA score for patients with Klebsiella pneumoniae sepsis was evaluated.Results:The results of univariate analysis showed that APACHE ? score,SOFA score,cerebral vascular disease,moderate and severe renal insufficiency,ALP and co2-cp were statistically significant(P < 0.05).Spearman correlation analysis showed that the mortality of patients with Klebsiella pneumoniae sepsis was positively correlated with APACHE ?(r = 0.772,P < 0.01)and sofa(r = 0.935,P < 0.01)scores.Multivariate logistic regression analysis showed that APACHE ? score(or = 1.113,95% CI: 1.022-1.211,P < 0.05),SOFA score(or = 1.282,95% CI: 1.133-1.451,P < 0.05),and cerebrovascular disease(or = 4.892,95% CI: 1.962-12.202,P < 0.05)were independent risk factors to evaluate the prognosis of these patients.The area under APACHE ? was 0.773 [95% CI(0.696-0.850),P < 0.001],and the area under sofa was 0.724 [95% CI(0.640-0.809,P < 0.001].The area under CCI was not statistically significant(P > 0.05).Conclusion:1.APACHE ?,SOFA score and cerebrovascular disease are independent risk factors for prognosis of patients with Klebsiella pneumoniae sepsis.2.The scores of APACHE ? and sofa in the survival group were lower than those in the death group.Both of them can predict the prognosis of patients with Klebsiella pneumoniae sepsis.3.APACHE ? combined with SOFA score has better effect on the prognosis of patients with Klebsiella pneumoniae induced sepsis.