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目的 调查感染性休克病死率和病死危险因素。方法 回顾性调查 1991～ 2 0 0 1年的 14 3例感染性休克患者 ,计算逐年病死率 ,采用单因素分析和多因素逐步Logistic回归 ,分析感染性休克病死危险因素。结果 1991～ 2 0 0 1年间 ,14 3例感染性休克患者总病死率 6 9 2 % (99/14 3) ,11年间病死率无显著变化(P =0 2 38)。感染性休克患者合并循环外器官功能衰竭数目增多 ,病死率增加。单纯循环衰竭者病死率4 6 7% (8/15 ) ,合并 1个循环外器官衰竭者病死率 4 8 3% (14 /2 9) ,2个循环外器官衰竭者 70 6 % (2 4 /34) ,当感染性休克患者合并 3个以上循环外器官衰竭者 ,病死率高达 85 7% (2 4 /2 8)以上。多因素逐步Logistic回归显示 ,感染性休克的病死危险因素是合并器官功能衰竭数目。结论 11年间 ,感染性休克的病死率无明显下降 ,防止器官功能损害是降低感染性休克病死率的关键
Objective To investigate septic shock mortality and mortality risk factors. Methods A retrospective study of 143 cases of septic shock from 1991 to 2001 was conducted to calculate annual fatality rate. Univariate analysis and multivariate stepwise Logistic regression were used to analyze the risk factors of septic shock. Results Between 1991 and 2001, the overall mortality of 14 3 septic shock patients was 69.2% (99/14 3). There was no significant difference in mortality over the 11 years (P = 0 2 38). Patients with septic shock combined with extra-circulatory organ failure increased the number of cases, mortality increased. The mortality rate of patients with simple circulatory failure was 46.7% (8/15). The mortality rate of those with single extra-circulatory organ failure was 48.3% (14/29), while those with two extra-circulatory organ failure were 70.6% (2 4 / 34). In patients with septic shock, more than 3 patients with organ failure outside the circulation had a mortality rate of more than 85 7% (24/28). Multi-factor Logistic regression showed that the risk of septic shock was the number of combined organ failure. Conclusions During the 11 years, there was no significant reduction in the mortality rate of septic shock and prevention of organ dysfunction was the key factor in reducing the mortality of septic shock