摘要
目的探讨肿瘤患者术后急性呼吸衰竭的住院病死率及其预后因素。方法回顾性分析中国医学科学院肿瘤医院ICU2004年1月至2006年12月收治的1632例肿瘤术后患者,急性呼吸衰竭(气管插管或气管切开且机械通气)447例,对死亡率进行单因素和多因素Logistic回归分析。结果447例急性呼吸衰竭患者中,死亡106例,病死率为6.5%。单因素分析显示急性疾病(休克、感染、器官功能衰竭)、治疗(持续肾脏替代治疗、使用血管活性药物)、28 d内未住ICU天数、APACHEⅡ≥20分与术后急性呼吸衰竭的死亡有关,具有统计学意义(P<0.05)。多因素Logistic回归分析显示手术时间(P=0.008,OR1.032,95%CI1.008～1.057)、APACHEⅡ≥20分(P=0.000,OR12.200,95%CI2.896～51.406)、器官功能衰竭(P=0.000,OR13.344,95%CI3.791～7.395)与急性呼吸衰竭的死亡有关。结论手术时间、器官功能衰竭、APACHEⅡ评分是肿瘤患者术后急性呼吸衰竭死亡的预后危险因素。
Objective To study the mortality and prognostic factors of post-operative acute respiratory failure in cancer patients. Methods There were 1632 postoperative cancer patients from 2004 to 2006 in the ICU of Cancer Hospital, in which 447 patients were complicated with acute respiratory failure （intubation or tracheotomy and mechanical ventilation ）. The clinical data was retrospectively analyzed. Stepwise logistic regression analysis was used to identify variables associated with mortality for acute respiratory failure. Results In 447 patients with acute respiratory failure （ male 260, female 187 ）, 106 cases died with a mortality of 6. 5%. Single factor analysis showed that acute morbodities （shock, infection, organ failure）,intervention （continuous renal replacement therapy, vasopressor drugs ）, the 28-day ICU free days and APACHE scores （ ≥20 ） had significant differences between the survivor and non-survivor. Multiple logistic regression analysis showed that duration of operation（ P = 0. 008, OR 1. 032,95% CI 1. 008-1. 057）, APACHE Ⅱ 1〉20 scores （ P = 0. 000, OR 12. 200,95% CI 2. 896-51. 406 ）, organ function failure（ P = 0. 000, OR 13. 344,95% CI 3. 791-7. 395 ） were associated with mortality of acute respiratory failure. Condusion Duration of operation, organ function failure, and APACHE Ⅱ scores were risk prognostic factors for postoperative cancer patients with acute respiratory failure.
出处
《中国呼吸与危重监护杂志》
CAS
2009年第5期469-472,共4页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
呼吸衰竭
病死率
预后因素
Respiratory failure
Mortality
Prognostic factors
