지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2016.1
- 수록면
- 334 - 341 (8page)
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초록· 키워드
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Background: The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock.
Methods: We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality.
Results: Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]).
Conclusions: Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED.
목차
등록된 정보가 없습니다.
참고문헌 (20)
참고문헌 신청
Dombrovskiy VY / 2007 / Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003 / Crit Care Med 35:1244~1250
Kim WY / 2012 / Analysis of progression in risk, injury, failure, loss, and end-stage renal disease classification on outcome in patients with severe sepsis and septic shock / J Crit Care 27(104):e1~e7
Ryoo SM / 2015 / Prognostic value of B-type natriuretic peptide with the sequential organ failure assessment score in septic shock / Am J Med Sci 349:287~291
Ryoo SM / 2015 / Prognostic value of timing of antibiotic administration in patients with septic shock treated with early quantitative resuscitation / Am J Med Sci 349:328~333
Singer M / 2016 / The third international consensus definitions for sepsis and septic shock (sepsis-3) / JAMA 315:801~810
Kim WY / 2012 / Analysis of progression in risk, injury, failure, loss, and end-stage renal disease classification on outcome in patients with severe sepsis and septic shock / J Crit Care 27(104):e1~e7
Ryoo SM / 2015 / Prognostic value of B-type natriuretic peptide with the sequential organ failure assessment score in septic shock / Am J Med Sci 349:287~291
Ryoo SM / 2015 / Prognostic value of timing of antibiotic administration in patients with septic shock treated with early quantitative resuscitation / Am J Med Sci 349:328~333
Singer M / 2016 / The third international consensus definitions for sepsis and septic shock (sepsis-3) / JAMA 315:801~810
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