PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to evaluate the epidemiology of septic shock (SS) associated with intraabdominal infections (IAI) as well as associated mortality and efficacy of early source control in a tertiary-care educational hospital.
UNASSIGNED: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 during night shifts in our centre were analyzed retrospectively.
UNASSIGNED: A total number of 390 patients were included. Overall, 30-day mortality was 42.5% on day 3, while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%), and the mortality rate was significantly lower in cases that were performed source control at any time during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%), source control was performed during the first 12 hours, and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)= 2.943, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.179-4.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA≥10 (p<0.001, OR=3.036, 95%CI=1.802-5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with 30-day mortality in logistic regression analysis.
UNASSIGNED: Source control has a vital importance in terms of mortality rates for IAI-related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.
UNASSIGNED: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 during night shifts in our centre were analyzed retrospectively.
UNASSIGNED: A total number of 390 patients were included. Overall, 30-day mortality was 42.5% on day 3, while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%), and the mortality rate was significantly lower in cases that were performed source control at any time during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%), source control was performed during the first 12 hours, and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)= 2.943, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.179-4.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA≥10 (p<0.001, OR=3.036, 95%CI=1.802-5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with 30-day mortality in logistic regression analysis.
UNASSIGNED: Source control has a vital importance in terms of mortality rates for IAI-related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.
摘要：
■本研究旨在评估与腹腔内感染（IAI）相关的感染性休克（SS）的流行病学，以及相关的死亡率和早期来源控制的有效性。
2013年12月至2022年10月在我们中心值夜班期间接受传染病顾问咨询的患有IAI的SS患者进行了回顾性分析。
■共纳入390名患者。总的来说,第3天30天死亡率为42.5%,第14天和第30天死亡率分别为63.3%和71.3%,分别。390例中123例（31.5%）通过手术或经皮手术进行了源控制，在SS期间随时进行源控制的病例中，死亡率显着降低（65/123-52.8％vs213/267-79.8％，p<0.001)。123例中有44例（35.7%），在最初的12小时内进行了源控制，与其他组相比，该组的死亡率显着降低（24/44-54.5％vs254/346-73.4％，p=0.009)。另一方面,女性（p<0.001，比值比（OR）=2.943，95CI=1.714-5.054），糖尿病（p=0.014，OR=2.284，95CI=1.179-4.424），碳青霉烯耐药革兰氏阴性病因（p=0.011，OR=4.386，95CI=1.398-13.759），SOFA≥10（p<0.001，OR=3.036，95CI=1.802-5.114），在logistic回归分析中,乳酸>3mg/dl(p<0.001,OR=2.764,95CI=1.562-4.891)和缺乏源控制(p=0.001,OR=2.796,95CI=1.523-5.133)与30天死亡率显著相关.
■源控制对于IAI相关的脓毒性休克患者的死亡率至关重要。我们的研究强调需要更多的研究，因为本分析表明，早期源控制并不表现为逻辑回归的保护因素。
2013年12月至2022年10月在我们中心值夜班期间接受传染病顾问咨询的患有IAI的SS患者进行了回顾性分析。
■共纳入390名患者。总的来说,第3天30天死亡率为42.5%,第14天和第30天死亡率分别为63.3%和71.3%,分别。390例中123例（31.5%）通过手术或经皮手术进行了源控制，在SS期间随时进行源控制的病例中，死亡率显着降低（65/123-52.8％vs213/267-79.8％，p<0.001)。123例中有44例（35.7%），在最初的12小时内进行了源控制，与其他组相比，该组的死亡率显着降低（24/44-54.5％vs254/346-73.4％，p=0.009)。另一方面,女性（p<0.001，比值比（OR）=2.943，95CI=1.714-5.054），糖尿病（p=0.014，OR=2.284，95CI=1.179-4.424），碳青霉烯耐药革兰氏阴性病因（p=0.011，OR=4.386，95CI=1.398-13.759），SOFA≥10（p<0.001，OR=3.036，95CI=1.802-5.114），在logistic回归分析中,乳酸>3mg/dl(p<0.001,OR=2.764,95CI=1.562-4.891)和缺乏源控制(p=0.001,OR=2.796,95CI=1.523-5.133)与30天死亡率显著相关.
■源控制对于IAI相关的脓毒性休克患者的死亡率至关重要。我们的研究强调需要更多的研究，因为本分析表明，早期源控制并不表现为逻辑回归的保护因素。
