CAJ | 학술논문

目的：通过分析老年多器官功能不全综合征(MODSE)患者的临床特征，以了解影响患者预后的危险因素。方法研究共纳入465例MODSE患者并录入相应的各项临床指标，根据28 d病死率分为生存组和死亡组，对单因素Logistic回归分析两组间差异有统计学意义的指标进行多因素Logistic回归分析，得出影响预后的危险因素。结果生存组患者的平均年龄为(75.90±7.23)岁，小于死亡组的(77.97±6.94)岁，动脉血乳酸浓度为(1.39±1.10) mmol/L，低于死亡组的(3.15±3.67) mmol/L，功能不全器官数为(2.76±0.87)个，少于死亡组的(3.73±1.04)个，APACHEⅢ(64.35±24.32)分，低于死亡组的(96.10±29.74)分，以上各项指标间比较差异均有统计学意义(P<0.05)。经多因素Logistic回归分析显示，年龄(P=0.009)、动脉血乳酸浓度(P=0.002)、功能不全器官数(P<0.001)和APACHEⅢ(P<0.001)是MODSE患者死亡的独立危险因素。结论年龄、动脉血乳酸浓度、功能不全器官数和APACHEⅢ是MODSE患者死亡的独立危险因素。
목적：통과분석노년다기관공능불전종합정(MODSE)환자적림상특정，이료해영향환자예후적위험인소。방법연구공납입465례MODSE환자병록입상응적각항림상지표，근거28 d병사솔분위생존조화사망조，대단인소Logistic회귀분석량조간차이유통계학의의적지표진행다인소Logistic회귀분석，득출영향예후적위험인소。결과생존조환자적평균년령위(75.90±7.23)세，소우사망조적(77.97±6.94)세，동맥혈유산농도위(1.39±1.10) mmol/L，저우사망조적(3.15±3.67) mmol/L，공능불전기관수위(2.76±0.87)개，소우사망조적(3.73±1.04)개，APACHEⅢ(64.35±24.32)분，저우사망조적(96.10±29.74)분，이상각항지표간비교차이균유통계학의의(P<0.05)。경다인소Logistic회귀분석현시，년령(P=0.009)、동맥혈유산농도(P=0.002)、공능불전기관수(P<0.001)화APACHEⅢ(P<0.001)시MODSE환자사망적독립위험인소。결론년령、동맥혈유산농도、공능불전기관수화APACHEⅢ시MODSE환자사망적독립위험인소。
Objective To analyze the prognostic risk factors of patients with multiple organ dysfunction syn-drome in the elderly (MODSE) by analyzing their clinical characteristics. Methods In this study, the clinical data of 465 patients with MODSE were collected. The patients were divided into two groups, the survival group and the death group, basing on the 28 d mortality. Multivariable logistic regression analysis was performed on indicators which had statistically significant differences in the univariate logistic regression analysis. Results Multivariate Logistic regres-sion analysis showed that the average age of the survival group (75.90 ± 7.23) was younger than that of the death group (77.97±6.94);the arterial blood lactate concentration of the survival group (1.39±1.10) was lower than that of the death group (3.15±3.67) mmol/L;the number of organ dysfunction cases of the survival group (2.76±0.87) was less than that of the death group (3.73 ± 1.04);and the APACHE Ⅲof the survival group (64.35 ± 24.32) was lower than that of the death group (96.10 ± 29.74); differences between the above indexes were statistically significant. Therefore, age (P=0.009), arterial blood lactate concentration (P=0.002), numbers of dysfunctional organs (P<0.001) and APACHEⅢ(P<0.001) were the risk factors of the death for MODSE patients. Conclusion Age, arterial blood lactate concentration, numbers of dysfunctional organs and APACHEⅢwere all independent risk factors of death for MODSE patients.