BMJ:探究脓毒症患者晚期死亡原因

2016-05-17 MedSci MedSci原创

BMJ:探究脓毒症患者晚期死亡原因本研究旨在确定脓毒症患者晚期死亡是否主要是由于预先存在的并发症所致,还是由于脓毒症本身所致。采用观察性研究设计,950名年龄≥65岁(1998-2010)脓毒症患者接受住院治疗,均有医疗保险。匹配了777名成年患者目前已出院,788名非脓毒症感染患者,504名急性无菌性炎症性疾病患者。主要研究结果为不同时间间隔的晚期(31天到2年)死亡率和死亡几率。结果发现,非

本研究旨在确定脓毒症患者晚期死亡是否主要是由于预先存在的并发症所致,还是由于脓毒症本身所致。

采用观察性研究设计,950名年龄≥65岁(1998-2010)脓毒症患者接受住院治疗,均有医疗保险。匹配了777名非住院成年患者,788名非脓毒症感染患者,504名急性无菌性炎症性疾病患者。主要研究结果为不同时间间隔的晚期(31天到2年)死亡率和死亡风险。

结果发现,非住院成年患者相比,脓毒症住院患者晚期死亡率绝对增加了22.1%(95% CI为 17.5%-26.7%) ;与非脓毒症感染患者相比,则晚期死亡率绝对增加了10.4% (5.4%-15.4%) ;与急性无菌性炎症性疾病相比,则晚期死亡率绝对增加16.2%了(10.2%-22.2%) 。至少2年脓毒症住院患者的晚期死亡率高于非住院成人患者。

总而言之,五分之一的存活脓毒症患者晚期死亡的原因并不能由患病之前的健康状况解释。

原始出处:

Hallie C Prescott, John J Osterholzer, et al., Late mortality after sepsis: propensity matched cohort study. BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2375.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1903512, encodeId=c6f51903512aa, content=<a href='/topic/show?id=c8aa6335ed5' target=_blank style='color:#2F92EE;'>#死亡原因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63357, encryptionId=c8aa6335ed5, topicName=死亡原因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=570c172, createdName=tigerlr98, createdTime=Mon Dec 05 15:17:00 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847996, encodeId=de52184e9966c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 10 20:17:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86892, encodeId=0c29868925a, content=值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86893, encodeId=864e8689350, content=值得学习!值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516334, encodeId=97a815163342f, content=<a href='/topic/show?id=a5598519866' target=_blank style='color:#2F92EE;'>#脓毒症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85198, encryptionId=a5598519866, topicName=脓毒症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd7310955580, createdName=dlwang_26703130, createdTime=Thu May 19 13:17:00 CST 2016, time=2016-05-19, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1903512, encodeId=c6f51903512aa, content=<a href='/topic/show?id=c8aa6335ed5' target=_blank style='color:#2F92EE;'>#死亡原因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63357, encryptionId=c8aa6335ed5, topicName=死亡原因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=570c172, createdName=tigerlr98, createdTime=Mon Dec 05 15:17:00 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847996, encodeId=de52184e9966c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 10 20:17:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86892, encodeId=0c29868925a, content=值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86893, encodeId=864e8689350, content=值得学习!值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516334, encodeId=97a815163342f, content=<a href='/topic/show?id=a5598519866' target=_blank style='color:#2F92EE;'>#脓毒症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85198, encryptionId=a5598519866, topicName=脓毒症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd7310955580, createdName=dlwang_26703130, createdTime=Thu May 19 13:17:00 CST 2016, time=2016-05-19, status=1, ipAttribution=)]
    2016-06-10 gaoxiaoe
  3. [GetPortalCommentsPageByObjectIdResponse(id=1903512, encodeId=c6f51903512aa, content=<a href='/topic/show?id=c8aa6335ed5' target=_blank style='color:#2F92EE;'>#死亡原因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63357, encryptionId=c8aa6335ed5, topicName=死亡原因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=570c172, createdName=tigerlr98, createdTime=Mon Dec 05 15:17:00 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847996, encodeId=de52184e9966c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 10 20:17:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86892, encodeId=0c29868925a, content=值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86893, encodeId=864e8689350, content=值得学习!值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516334, encodeId=97a815163342f, content=<a href='/topic/show?id=a5598519866' target=_blank style='color:#2F92EE;'>#脓毒症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85198, encryptionId=a5598519866, topicName=脓毒症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd7310955580, createdName=dlwang_26703130, createdTime=Thu May 19 13:17:00 CST 2016, time=2016-05-19, status=1, ipAttribution=)]
    2016-05-23 WEIXIN82f774b2

    值得学习!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1903512, encodeId=c6f51903512aa, content=<a href='/topic/show?id=c8aa6335ed5' target=_blank style='color:#2F92EE;'>#死亡原因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63357, encryptionId=c8aa6335ed5, topicName=死亡原因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=570c172, createdName=tigerlr98, createdTime=Mon Dec 05 15:17:00 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847996, encodeId=de52184e9966c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 10 20:17:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86892, encodeId=0c29868925a, content=值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86893, encodeId=864e8689350, content=值得学习!值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516334, encodeId=97a815163342f, content=<a href='/topic/show?id=a5598519866' target=_blank style='color:#2F92EE;'>#脓毒症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85198, encryptionId=a5598519866, topicName=脓毒症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd7310955580, createdName=dlwang_26703130, createdTime=Thu May 19 13:17:00 CST 2016, time=2016-05-19, status=1, ipAttribution=)]
    2016-05-23 WEIXIN82f774b2

    值得学习!值得学习!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1903512, encodeId=c6f51903512aa, content=<a href='/topic/show?id=c8aa6335ed5' target=_blank style='color:#2F92EE;'>#死亡原因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63357, encryptionId=c8aa6335ed5, topicName=死亡原因)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=570c172, createdName=tigerlr98, createdTime=Mon Dec 05 15:17:00 CST 2016, time=2016-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1847996, encodeId=de52184e9966c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Jun 10 20:17:00 CST 2016, time=2016-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86892, encodeId=0c29868925a, content=值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86893, encodeId=864e8689350, content=值得学习!值得学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160523/IMG5742E99A74ECB3929.jpg, createdBy=74881728027, createdName=WEIXIN82f774b2, createdTime=Mon May 23 22:58:00 CST 2016, time=2016-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516334, encodeId=97a815163342f, content=<a href='/topic/show?id=a5598519866' target=_blank style='color:#2F92EE;'>#脓毒症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85198, encryptionId=a5598519866, topicName=脓毒症患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dd7310955580, createdName=dlwang_26703130, createdTime=Thu May 19 13:17:00 CST 2016, time=2016-05-19, status=1, ipAttribution=)]

相关资讯

Sciene:抗癌药喜树碱可能用于脓毒症的治疗

炎症是把双刃剑,最基本功能之一是防御微生物入侵。严重炎症(脓毒症)也可以造成血容量不足,导致器官功能衰竭,危害健康甚至生命。脓毒症是导致住院患者死亡的最重要原因之一,只美国每年就有25万患者死于该病,但是对脓毒症,临床上一直缺乏特异性治疗药物。2016年4月28日发表在《科学》一项研究显示,一些抗癌药物喜树碱(Camptothecin)具有控制过度炎症的作用,或许能成为治疗脓毒症的药物。按照这个研

JAMA:脓毒症入住ICU后继发感染的发生率、死亡率研究

脓毒症可诱导免疫抑制,导致继发感染的易感性增加,增加患者晚期死亡率。研究者对ICU患者进行了一项研究,探究伴或不伴脓毒症患者获得性感染的临床和宿主的基因组学特征、发病率和住院死亡率(ICU)。以ICU获得性感染(发病>48小时)为主要终点。通过时间-事件模型计算死亡率风险(部分死亡率可以通过消除危险因素、获得性感染得以预防)。对脓毒症患者(n = 461)亚组分析时,在基线和发生ICU获得性感染(

Am J Pathol:新研究为脓毒症的治疗奠定了基础

发表于American Journal of Pathology的一项新的研究揭示了对抗脓毒症的基础——SHARPIN,一种参与炎症调节的蛋白。

Chest:治疗脓毒症期间房颤——β受体阻滞剂优于CCBs

脓毒症期间发生房颤(AF)增加发病率和死亡率,但在脓毒症期间有针对性的治疗AF心率和节律的实践模式和结果目前还不清楚。该项回顾性队列研究的数据来自于约20%的美国医院。研究人员确定了脓毒症期间IV级AF治疗的相关因素(β受体阻滞剂[BBs],钙通道阻滞剂[CCBs],地高辛,或胺碘酮)。研究人员使用倾向得分匹配和工具变量的方法来比较不同治疗房颤方法之间的死亡率。在39693例脓毒症期间发生房颤的患

JAMA:第三次国际共识|脓毒症临床标准评价

第三次国际共识定义任务组将脓毒症定义为“由于机体对感染的特异性反应产生的威胁生命的器官功能障碍”。但对于脓毒症临床表现诊断标准的定义尚不清楚。

JAMA:脓毒症休克的新定义和临床评价标准

背景和目的:脓毒症休克是指一种与感染有关的急性循环衰竭的状态。新的生物学研究和流行病学挑战改变了其原本定义的有效性。本研究的目的是探讨成人脓毒症休克的新定义和临床标准。