Analysis Of Risk Factors In Death Of Elderly Septic Patients

Objective: The present study is aimed to explore the risk factors of sepsis in senile patients with sepsis,based upon criteria of Sepsis 3.0.Methods: 134 senile patients with sepsis in the Department of Critical Care Medicine of Huangshan People’s Hospital Affiliated to Wannan Medical College from October2017 to October 2018 were reviewed retrospectively.The diagnosis of sepsis complies with the diagnostic criteria of the Surviving Sepsis Campaign(SSC)Guidelines 2016,namely the diagnostic criteria of sepsis 3.0.According to the outcome of 28 days,patients were divided into survival group and death group,and then statistical analysis was carried out.Univariate logistic regression analysis was used to screen out the possible related risk factors of death in senile patients with sepsis,which then entered multivariate regression analysis to fit the model,and screened out the high risk factors of death in senile patients with sepsis.In multivariate logistic regression analysis,the maximum partial likelihood ratio test(LR)was used to screen the independent variables.The fitting effect of the prediction model of mortality risk of senile patients with sepsis and the judgment efficacy of individual independent risk factors of death of senile patients with sepsis were analyzed by Receiver Operating Characteristic Curve(ROC curve).The results were bilateral,and the statistical significance was shown with P <0.05.Results: Among 134 patients,94(70.15%)were males,40(29.85%)were females,41died(30.59%)and 93 survived(69.40%),62 with septic shock(46.27%)and 40 cases with acute renal injury(29.85%).Univariate logistic regression analysis showed that age,APACHE II scores,SOFA scores,acute renal injury(AKI),hypertension,white blood cell count,platelet count,prothrombin time,arterial PH value,arterial blood lactate value,alanine aminotransferase,serum creatinine,cystatin C,mechanical ventilation time and blood urea nitrogen were risk factors for death in senile patients with sepsis(all P < 0.05).Multivariate logistic regression analysis showed that age[odds ratio(OR)=8.557,95% confidence interval(95% CI)2.817-25.998,P < 0.001],SOFA score(OR=1.946,95% CI 1.375-2.756,P < 0.001),platelet count(OR=5.226,95% CI 2.086-13.094,P < 0.001),white blood cell count(OR = 1.851,95% CI1.064-3.220,P = 0.029)are independent risk factors for death in senile patients with sepsis.Conclusion: Age,SOFA scores,platelet count and white blood cell count were independent risk factors for death in senile patients with sepsis.