Risk Factors Affecting The Prognosis Of Patients With Sepsis In ICU

Objective: To investigate analysis of the risk factors of the prognosis of patients with sepsis in Intensive Care Unit.Methods:The study subjects are 200 septic patients who have been accepted by General Hospital of Tianjin Medical University during June 2013 and June 2014 with complete data.The diagnostic standards of sepsis are executed as follows.Firstly,collect the information of the patients’ ages,genders, vital signs, BMI, ICU hospital stays, underlying diseases. After that, laboratory inspections like blood routine,electrolytes, arterial blood gas, liver function, kidney function and Gl U are needed.Besides, measure LAC value, calculate actate clearance in 24 hours after hospitalization,record laboratory data like WBC,PLT,TBi L,oxygenation index,ALT,CK-MB,CR,BUN,AST,ALB and count APACHE grade, GCS grade and SOF grade. According to the prognosis during the hospitalization, the patients are seperated into two groups. Then, record these data to Excel system and process them with statistical software SPSS21.0. When taking part in normality test, quantitative data with normal distribution are expressed with( x ±s), measurement data of nomal distribution and variances are verified with t and counting data are verified with x2. In addition, simple factor analysis is firstly taken as an affecting factor of prognosis of septic patients. Thus, multivariate regression analysis will be avaliable on the basis of indicators of simple factor analysis.Results:(1)The death group and the survival group have no differences among average ages, joint urinary infection, gastrointestinal bleeding, respiratory failure,diabetes, COPD, arute myocardial infarction, hypertension, TPN, duration of mechanical ventilation, ICU hospitalstays and they do not have statistical significance(P>0.05). However, the death group and the survival group have differences among the age,anticoagulant therapy, continuous blood purification, joint ARDS, joint AKI, joint fungal infection, joint DIC,, cardiac insufficiency and they have statistical significance(P<0.05).The death group and the survival group have no differences among WBC, TBIL, PLT, oxygenation index,ALT,CK-MB,CR,BUN,AST,ALB,PT and they do not have statistical significance(P>0.05). The death group and the survival group have differences among LAC, CRP,PCT,24 h lactate clearance, APACHEⅡgrade, SOFA grade and they have statistical significance(P<0.05).(2)Simple factor analysis reveals that age、PCT、Lac、SOFA grade, 24 h lactate clearance, combining with fungal infection, AKI, ARDS,DIC, anticoagulanttherapy, continuous blood purification are the relevant factors of prognosis of septic patients.(3)Multivariate regression analysis reveals that APACHEⅡgrade, 24 h lactate clearance,combining with ARDS and DIC are the risk factors of prognosis of septic patients(P<0.05).Conclusions:(1) The prognosis of patients with sepsis in the ICU are basic diseases,microbial infection, complication, interventional therapy, and other factors.(2)APACHEⅡgrade,24 h lactate clearance,ARDS and DIC are contributing to the risk factors of prognosis of septic patients in ICU.