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1、ICU患者病死率危险因素的前瞻性临床研究论文【摘要】目的探讨影响ICU患者病死率主要危险因素，以制定有效措施。方法对入住本院ICU超过48h的住院患者及入住ICU48h内死亡的住院患者，进行为期2年的前瞻性监测。排除年龄＜16岁的住院患者。结果共监测276例病例，病死率为44.9%。99例(35.9%)发生医院感染。独立危险因素有平均年龄(HR1.08，95%CI0.98～1.15)、APACHEII评分(HR2.01，95%CI1.62～2.87)、机械通气(HR1.87，95%CI1.38～2.92)、医院感染(HR0.41，95%CI0.31～0
2、.68)、鼻饲(HR0.51.freelortalityinintensivecareunits:aprospectivestudy【Abstract】ObjectiveToinvestigateriskfactorsformortalityinintensivecareunits.MethodsTheprospectivestudyedfromJanuary2005toNovember2006inICU.276patientsortalityanalysis.ResultsTheoverallmortalityrateintheICUongthe27
3、6patients,99(35.9%)hadnosoialinfections.Themeanage,sex,acutephysiologyandchronichealthevaluation(APACHE)IIscore,traumaandintraabdominalpathology,nosoialinfection,stayinICU,a,TISSscore,useofsteroidorchemotherapy,useofantibioticortalityintheunivariateanalysis.Eightvariablesinedasi
4、ndependentriskfactors:meanage(HR1.08，95%CI0.98～1.15),.freeleanAPACHEIIscore(HR2.01，95%CI1.62～2.87),mechanicalventilation(HR1.87，95%CI1.38～2.92),nosoialinfection(HR0.41，95%CI0.31～0.68),enteralnutrition(HR0.51，95%CI0.32～0.69),stayinICU(HR,0.45;95%CI,0.24～0.60),useofsteroidorchemot
5、herapy(HR1.58，95%CI1.18～2.09),andtracheostomy(HR0.31，95%CI0.01～0.69).ConclusionThemostimportantriskfactorsofmortalityechanicalventilation,enteralnutrition,tracheostomy,anduseofsteroidsorchemotherapy.【KeyerD,ChenHC.AparisionofinfectionindifferentICUsehospital.CritCareMed,1985,13:
6、472-476.2DaschnerF.Nosoialinfectionsinintensivecareunits.CritCareMed,1985,11:284-287.3AppelgrenP,HellstromI,,LichtenbergDA,etal.Nosoialinfectionandfatalityinmedicalandsurgicalintensivecareunitpatients.ArchInternMed,1988,148:1161-1168.5VincentJL.Nosoialinfectionsinadultintensive-
7、careunits.Lancet,2003,361:2068-2077.6RordorfG,Koroshetzed,2000,28:1301-1305.7IbrahimEH,ShermanG,ed,2004,32:1149-1154.9StephanF,CheffiA,BonF.Nosoialinfectionsandouteofcriticallyillelderlypatientsaftersurgery.Anesthesiology,2001,94:407-414.10Rockittedtointensivecareunits.CritCareM
8、ed,1993,21:687-691.11NiskanenM,KariA,NikkiP,eta
