https://scholars.lib.ntu.edu.tw/handle/123456789/588096
標題: | Clinical Trajectories and Causes of Death in Septic Patients with a Low APACHE II Score | 作者: | CHUN-TA HUANG SHENG-YUAN RUAN Tsai, Yi-Ju SHIH-CHI KU CHONG-JEN YU |
關鍵字: | acute physiology and chronic health evaluation; intensive care unit; outcome; risk factor; sepsis;Acute physiology and chronic health evaluation; Intensive care unit; Outcome; Risk factor; Sepsis | 公開日期: | 20-七月-2019 | 卷: | 8 | 期: | 7 | 來源出版物: | Journal of clinical medicine | 摘要: | Clinical course and mortality in septic patients with low disease severity remain poorly understood and is worth further investigation. We enrolled septic patients admitted to intensive care units (ICUs) between 2010 and 2014 with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of ≤15. We sought to determine their clinical trajectories and causes of death, and to analyze risk factors associated with in-hospital mortality. A total of 352 patients were included, of whom 89 (25%) did not survive to hospital discharge, at a rate higher than predicted (<21%) by the APACHE II score. Approximately one third (31/89) of non-survivors succumbed to index sepsis; however, more patients (34/89) died of subsequent sepsis. New-onset ICU sepsis developed in 99 (28%) patients and was an independent risk factor for mortality. In addition, septic patients with comorbid malignancy or index infection acquired in the hospital settings were more likely to have in-hospital mortality than those without. In conclusion, septic patients with low APACHE II scores were at a higher mortality risk than expected, and subsequent sepsis rather than index sepsis was the primary cause of death. This study provides insight into unexpected clinical trajectories and outcomes of septic patients with low disease severity at ICU admission and highlights the need for more research and clinical attention in this patient population. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/588096 | ISSN: | 2077-0383 | DOI: | 10.3390/jcm8071064 | SDG/關鍵字: | adult; aged; APACHE; Article; bacteremia; cardiovascular disease; cause of death; critically ill patient; disease severity; female; fungemia; hospital discharge; hospital mortality; hospitalization; human; immunocompromised patient; intensive care unit; length of stay; major clinical study; male; mortality risk; multiple organ failure; outcome assessment; patient safety; retrospective study; sepsis |
顯示於: | 醫學系 |
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