CAJ | 학술논문

目的探讨ICU颅脑损伤患者发热发生的危险因素以及发热与病死率相关性。方法对入选的72例患者临床资料进行分析，脑损伤患者患者分别按性别、年龄（±2年）、以及疾病的严重程度（APACHE-域评分±5分）与非脑损伤患者进行匹配。入住ICU第一个24h内的最高温度高于37.5℃者确定为发热。主要转归指标为病死率。结果36例脑损伤患者年龄为65.5±14年，47豫为男性，平均APACHE-域评分为15（IQR11-20）。平均住院时间脑损伤患者明显低于非脑损伤患者。相较于非神经系统患者来说，脑损伤患者的平均最高温度更高，入住ICU后脑损伤患者发热更易出现。两组相比较脑损伤患者病死率高于非脑损伤患者(30%vs 20%,<0.05)。在单因素分析中，入ICU后发烧与病死率相关。在多因素分析中，APACHE-域，神经系统疾病，MAP，循环系统与呼吸系统功能衰竭，发热均与院内病死率相关。结论脑损伤后发热经常发生，且与院内病死率相关。
목적탐토ICU로뇌손상환자발열발생적위험인소이급발열여병사솔상관성。방법대입선적72례환자림상자료진행분석，뇌손상환자환자분별안성별、년령（±2년）、이급질병적엄중정도（APACHE-역평분±5분）여비뇌손상환자진행필배。입주ICU제일개24h내적최고온도고우37.5℃자학정위발열。주요전귀지표위병사솔。결과36례뇌손상환자년령위65.5±14년，47예위남성，평균APACHE-역평분위15（IQR11-20）。평균주원시간뇌손상환자명현저우비뇌손상환자。상교우비신경계통환자래설，뇌손상환자적평균최고온도경고，입주ICU후뇌손상환자발열경역출현。량조상비교뇌손상환자병사솔고우비뇌손상환자(30%vs 20%,<0.05)。재단인소분석중，입ICU후발소여병사솔상관。재다인소분석중，APACHE-역，신경계통질병，MAP，순배계통여호흡계통공능쇠갈，발열균여원내병사솔상관。결론뇌손상후발열경상발생，차여원내병사솔상관。
Objective To evaluate the predictors of fever with in patients,and to study the ef ect of fever on in-hospital case fatality.Methods Retrospective data col ection of consecutive patients admit ed to the intensive care unit(ICU).Neurological patients were matched by sex,age,and Acute Physiology and Chronic Health Evaluation II(APACHE-II) to a cohort of nonneurological patients.Fever was defined as any temperature>37.5℃within the first 24 hours upon admission to the ICU.The primary outcome measure was in-hospital case fatality.Results Mean age among neurological patients was 65.5±14 years,47%were men,and median APACHE-II was 15 (interquartile range 11-20).More neurological patients experienced fever than nonneurological patients.The mean hospital length of stay was higher for nonneurological patients,and more neurological patients were dead at hospital discharge (30%vs 20%, <0.05).The fol owing variables were associated with higher in-hospital case fatality:APACHE-II,neurological diagnosis,mean arterial pressure,cardiovascular and respiratory dysfunction in ICU,and fever.Conclusion These data suggest that fever is a frequent occurrence after brain injury,and that it is associated with in-hospital case fatality.