浙江医学2017，Vol.39Issue(9)：716-719,726,5.DOI:10.12056/j.issn.1006-2785.2017.39.9.2017-167
影响脓毒症预后因素的多元Cox回归模型分析
Cox regression analysis of risk factors for the prognosis of sepsis
摘要
Abstract
Objective To analyze the risk factors for the prognosis of sepsis and to establish a functional model based on Cox regression.Methods A total of 384 patients with sepsis admitted at intensive care uni (ICU) from January 2010 to January 2016 were enrolled in the study.The clinical indicators at admission and outcomes at 28 days after admission were analyzed by Cox regression,and a functional model for prognosis was established.Results The case fatality rate during 28 days after admission was 61.98％(238/384).Univariate analysis showed that acute physiology and chronic health evaluation (APACHEⅡ) score,acute kidney injury (AKI),high density lipoprotein (HDL-C),blood urea nitrogen(BUN) and blood calcium (Ca2+),peripheral blood lymphocyte count (LY),platelet count (Plt) and sequential organ failure assessment (SOFA)score were significantly associated with the case fatality (all P＜0.05).Cox regression analysis showed that bowel surgery [(RR=6.371,95％CI:4.266,8.536),P＜0.01],blood glucose [(RR=1.008,95％CI:1.045,1.133),P＜0.01],HDL-C [(RR=0.683,95％CI:0.418,0.824),P＜0.01],BUN [(RR=1.068,95％CI:1.009,1.130),P＜0.05],Ca2+ [(RR=0.274,95％CI:0.141,0.533),P＜0.01],LY [(RR=0.322,95％CI:0.210,0.495),P＜0.01],Plt [(RR=0.996,95％CI:0.992,1.000),P＜0.05] and SOFA score [(RR=0.894,95％CI:0.795,1.043),P＜ 0.01)] were independent risk factors for the prognosis of patients with sepsis.A function model for the prognosis of sepsis was established according to Cox regression analysis:h(t,X)=h0(t) exp (prognostic index=6.371X1+ 1.249X2+ 1.088X3-0.683X4+ 1.068X5-0.274X6+0.322X7+0.996X8+0.894X9).Conclusion Bowel surgery,blood glucose,high density lipoprotein,blood urea nitrogen,blood calcium,blood lymphocyte count and platelet count and SOFA score are independent risk factors for the prognosis of patients with sepsis.关键词
脓毒症/预后/Cox回归/危险因素Key words
Sepsis/Prognosis/Cox regression/Risk factors引用本文复制引用
倪银,叶珺,王金柱,韩芳,吴爱萍,孙仁华..影响脓毒症预后因素的多元Cox回归模型分析[J].浙江医学,2017,39(9):716-719,726,5.基金项目
浙江省科技厅重症医学科技创新团队项目(2011R50018) （2011R50018）
浙江省医药卫生平台计划(2015RCB003) （2015RCB003）
