응급실을 통해 입원한 패혈증 혹은 패혈성 쇼크 환자에서 생존에 영향을 미치는 인자 (The Factors Affect that Survival of Sepsis or Septic Shock Patients Admitted through Emergency Department)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 19권 / 4호 / 398 ~ 404페이지
· 저자명 : 변재민, 홍훈표, 최한성, 고영관, 조한진

초록

Purpose: We sought to determine the impact of the factors
that affect the mortality of critically ill patients with sepsis or
septic shock.
Methods: We performed a retrospective cohort study of
adult patients admitted with sepsis or septic shock from April
1, 2006, to December 31, 2007, at a single, urban academic
emergency department (ED). The primary outcome was
patients’ death. Predictor variables were the EDLOS, the
time from registration to order for antibiotics administration,
number of hospital days, initial systolic blood pressure, systolic
blood pressure after hydration, heart rate, respiration
rate, body temperature, serum white blood cell count, and
serum lactic acid level. Cox’s proportional hazard model was
used to elucidate the relationship of predictor variables to
patients’ death. Data were analyzed with SPSS version 12.0.
Results: The overall mortality rate was 56.2%. Average
length of stay was 204.5±90.6 minutes in the survival
group and 166.6±81.8 minutes in the death group
(p=0.041). The mortality was not shown to be significantly
different between patients spending less than 4 hours and
patients spending over 4 hours. The relative risk (RR) for
patients’ death was significantly higher in patients with
hypotension persisting despite adequate fluid resuscitation.
Conclusion: EDLOS did not affect mortality for the patients
admitted with sepsis or septic shock. The patients’ prognoses
were mainly related to the systolic blood pressure
after hydration.

영어초록

Purpose: We sought to determine the impact of the factors
that affect the mortality of critically ill patients with sepsis or
septic shock.
Methods: We performed a retrospective cohort study of
adult patients admitted with sepsis or septic shock from April
1, 2006, to December 31, 2007, at a single, urban academic
emergency department (ED). The primary outcome was
patients’ death. Predictor variables were the EDLOS, the
time from registration to order for antibiotics administration,
number of hospital days, initial systolic blood pressure, systolic
blood pressure after hydration, heart rate, respiration
rate, body temperature, serum white blood cell count, and
serum lactic acid level. Cox’s proportional hazard model was
used to elucidate the relationship of predictor variables to
patients’ death. Data were analyzed with SPSS version 12.0.
Results: The overall mortality rate was 56.2%. Average
length of stay was 204.5±90.6 minutes in the survival
group and 166.6±81.8 minutes in the death group
(p=0.041). The mortality was not shown to be significantly
different between patients spending less than 4 hours and
patients spending over 4 hours. The relative risk (RR) for
patients’ death was significantly higher in patients with
hypotension persisting despite adequate fluid resuscitation.
Conclusion: EDLOS did not affect mortality for the patients
admitted with sepsis or septic shock. The patients’ prognoses
were mainly related to the systolic blood pressure
after hydration.

참고자료

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