| 陈贺,邬海燕,傅涓涓,等.终末期肝病合并血流感染病人预后影响因素[J].安徽医药,2022,26(6):1124-1128. |
| 终末期肝病合并血流感染病人预后影响因素 |
| Influencing factors on the prognosis of patients with end-stage liver disease and bloodstream infection |
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| DOI：10.3969/j.issn.1009-6469.2022.06.014 |
| 中文关键词: 终末期肝病 细菌感染 血流感染 病原菌 预后 影响因素 |
| 英文关键词: End stage liver disease Bacterial infections Bloodstream infection Pathogen Prognosis Influencing factors |
| 基金项目:十三五艾滋病和病毒性肝炎等重大传染病防治( 2018ZX10302206) |
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| 中文摘要: |
| 目的探究终末期肝病合并血流感染病人预后的影响因素。方法回顾性收集 2013年 1月至 2018年 8月徐州医科大学附属医院收治的终末期肝病合并血流感染病人( n=139例)的临床数据。根据病人出院时治疗效果，分为有效组( n=105例)和无效组( n=34例)。采用单因素分析和多因素 logistic回归分析终末期肝病合并血流感染病人不同临床结局的影响因素。结果入组病人共 139例，其中有效组病人 105例( 75.5%)，无效组病人共 34例( 24.5%)。单因素分析提示，住院时间［ 18.50 |
| 英文摘要: |
| Objective To investigate the prognostic factors of patients with end-stage liver disease complicated with bloodstream in‐fection.Methods The clinical data of patients with end-stage liver disease and bloodstream infection admitted to the Xuzhou MedicalUniversity Affiliated Hospital from January 2013 to August 2018 were retrospectively collected. The patients were divided into an effective group and an ineffective group according to the treatment effect at the time of discharge from the hospital. Univariate analysis andmultivariate logistic regression were used to analyze the prognostic factors of different clinical outcomes in patients with end-stage liver disease and bloodstream infection.Results A total of 139 patients were enrolled, including 105 patients (75.5%) in the effective groupand 34 patients (24.5%) in the ineffective group. Univariate analysis suggested that hospital days [18.50 (14.00, 25.00) d vs. 12.00 (3.00, 25.25) d], Model for End-Stage Liver Disease (MELD) score (13.50±7.30) vs. (20.40±11.70), MELD with incorporation of sodium (MELD-Na) score (11.49±12.71) vs. (24.15±19.55), liver failure (23.8% vs. 61.8%), 24-hour body temperature improvement (59.0% vs. 38.2%), hepatorenal syndrome (0% vs. 14.7%) and septic shock (0% vs. 11.8%) were statistically different between the effective and ineffective groups (all P<0.05). Multivariate logistic regression analysis indicated that liver failure [OR=3.820, 95%CI: (1.437, 10.156)], a history of peritonitis [OR=3.499, 95%CI: (1.007, 12.155)], body temperature improvement within 24 hours [OR=2.826, 95%CI: (1.117, 7.147)], and MELD-Na score [OR=1.039, 95%CI: (1.007, 1.072)] are independent factors affecting the treatment effect of patients with end-stage liver disease and bloodstream infection (all P<0.05).Conclusion Liver failure, past history of peritonitis, unimproved body temperature within 24 hours, and high MELD-Na score are independent risk factors for clinical treatment failure in patients with end-stage liver disease and bloodstream infection. |
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