Abstract
Objective:To explore the incidence of sepsis and related risk factors during hospitalization in patients with polytrauma and a history of malignant tumor.Methods:A retrospective cohort study was conducted,and a total of 405 pa-tients with polytrauma admitted to Suining Central Hospital from November 2019 to December 2024 were consecutively in-cluded as study subjects,with their general information,clinical data,and laboratory test results recorded.According to the Sepsis 3.0 guidelines and with 28 days of hospitalization as the observation endpoint,patients with polytrauma were assigned to sepsis and non-sepsis groups,the incidence of sepsis was calculated,1:1 propensity score matching(PSM)was per-formed,and a logistic regression model was subsequently used to analyze the risk factors for sepsis during hospitalization after PSM.Results:127 patients developed sepsis during hospitali-zation,with an incidence of 31.36%.Univariate analysis showed that,compared with patients without sepsis,those with multiple trauma and sepsis had a higher average age,a higher proportion of patients aged≥60 years,a greater number of injured body regions,a higher proportion of patients with active tumors,higher initial acute physiology and chronic health evaluation II score,sequential organ failure assessment(SOFA)score,and injury severity score within 24 hours of admis-sion,a higher rate of mechanical ventilation,and significantly elevated blood cell count,neutrophil-to-lymphocyte ratio,lac-tate,C-reactive protein,and procalcitonin(PCT).In contrast,the Glasgow Coma Scale(GCS)score,red blood cell count(RBC),and platelet count(PLT)were significantly lower in the sepsis group.All differences were statistically significant(all P<0.05).After PSM,the distribution of demographic factors was comparable between groups(all P>0.05).Multi-variate logistic regression analysis showed that SOFA score,GCS score,RBC,PLT,active tumor,and PCT were independ-ent risk factors for sepsis during hospitalization in patients with polytrauma(all P<0.05),with OR values of 1.200,0.745,0.593,0.994,1.225,and 4.912,respectively.Conclusion:SOFA score,GCS score,RBC count,PLT count,active malignant tumor,and PCT are independent risk factors for sepsis during hospitalization in polytrauma patients.These indicators can provide evidence for evaluating clinical conditions and identifying sepsis high-risk groups among polytrauma pa-tients.关键词
恶性肿瘤病史/多发伤/脓毒症/危险因素/Logistic回归模型/倾向性评分匹配法Key words
History of malignant tumors/Polytrauma/Sepsis/Risk factors/Logistic regression model/Propensity score matching分类
医药卫生
