icu重症社区获得性肺炎临床特征和预后因素研究及预测模型的建立-study on clinical features and prognostic factors of icu severe community-acquired pneumonia and establishment of prediction model.docx

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2018-05-29 发布于上海
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icu重症社区获得性肺炎临床特征和预后因素研究及预测模型的建立-study on clinical features and prognostic factors of icu severe community-acquired pneumonia and establishment of prediction model.docx

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icu重症社区获得性肺炎临床特征和预后因素研究及预测模型的建立-study on clinical features and prognostic factors of icu severe community-acquired pneumonia and establishment of prediction model

ABSTRACTBackgroundand0bjective:SeverecommunityacquiredpneumoniaiscommonincriticallyillpatientsinICU.Inrecentyears,despitethecontinuedemergenceofnewbroad-spectrumantibiotics,monitoringtechnologyandorganfunctionsupporttechnologyisalsorising,astheagingpopulation,reducedfunctionofhostdefense,changesinpathogensandtheriseofantibioticresistance,SCAPisstilladifficultdiseaseswithhighincidence,highmortalityandhighcost.Howtoreduceitsmortalityandimproveprognosis,isalwaysacliniciantobeoneoftheseverechallengesfacing.Therefore,theobjectiveandaccurateassessmentofprognosticfactorsinpatientswithSCAP,analyzeandsummarizetheetiology,statusofclinicaldiagnosisandtreatment,willhelptounderstandthedevelopmenttrendofthediseaseandprognosis,forclinicianstodeterminethepatientsconditionandprognosisandtodevelopreasonabletreatmentprogramsforreference.Practice.ThisstudywasretrospectiveanalysisofpatientswithSCAPinourhospitalICUintheclinicalcharacteristics,commonpathogensandprognosticfactors,toanalyzetheindependentprognosticriskfactorsofSCAP.Methods:Aretrospectivecase-controlstudy,collectedfromMarch2009toJune2010ICUpatients’dataintheclinicaldiagnosisofSCAPoftheSecondAffiliatedHospitalofGuangzhouMedicalCollege,whichweredividedintocasegroups(deathgroup)andcontrolgroup(survivalgroup)accordingtotheirprognosis，andtoanalyzetheriskfactors,clinicalfeatures,diagnosisandetiologicaltypeofsituation,theuseofLogisticregression,planstoestablishtheprognosisofpatientswithSCAPassessmentclassificationequation.Results：March2009toJune2010inourhospitalICUdischargediagnosisofpneumonia(age=18years)of102casesofseverepneumoniacasesmetthediagnosticcriteria,selectedpatientswithseverecommunity-acquiredpneumoniain70cases,40casesofdeath,mortality57.1%.3casesofthemdiedwithin24hoursintotheICU,2patientsdischargedin24hoursintotheICU，6Casesdischargedcured,univariateanalysisincluded59casesofpatients,male39cases,accountingfor66.1%,female20cases,accountingfor33.9%,agefrom19to91yearsold,meanage68.80±17.45years,withamedianageof75.Theaveragel