摘要
背景:医院感染在自发性蛛网膜下腔出血(SAH)患者中很常见。这项回顾性队列研究的目的是确定SAH期间感染的发生率,并评估炎症参数的过程及其对长期预后的影响。 目的:纳入九十九名连续盘卷的SAH患者。实验室和临床参数以及培养阳性感染均遵循疾病进展。 Glasgow结果评分(GOS)评估6个月,有利(GOS> 3)和不良结局(GOS≤3)两项评估。 结果:最常见的感染是肺(30.3%)尿路(25.3%),血流感染(20.2%)和脑室炎(5.1%)。感染的发生率在结局组之间没有显着差异。相比之下,不良结局的患者脓毒症发病率较高(46.7%,而24.6%)。 C反应蛋白(CRP)和白细胞显着高于不良结局患者。 SAH后头3天的CRP增加6 mg / dl或更高,与不良结局独立相关(OR 7.19 CI 1.7-30.52; p = 0.008)。早期CRP增加的患者在入院后的前3天更经常用抗菌治疗治疗,导致后期培养阳性感染的发生率显着降低。 结论:SAH急性期CRP急剧上升可能有助于早期发现神经系统发病高风险患者的集结。早期的抗微生物治疗降低了在疾病过程中显示培养阳性感染的患者的发生率。
关键词: 炎症,结局,感染,C反应蛋白,蛛网膜下腔出血,神经炎症。
图形摘要
Current Drug Targets
Title:Nosocomial Infections and Antimicrobial Treatment in Coiled Patients with Aneurysmal Subarachnoid Hemorrhage
Volume: 18 Issue: 12
关键词: 炎症,结局,感染,C反应蛋白,蛛网膜下腔出血,神经炎症。
摘要: Background: Nosocomial infections are common in patients with spontaneous subarachnoid hemorrhage (SAH). The aim of this retrospective cohort study was to determine the incidence of infections during SAH and to evaluate the course of inflammation parameters and its implications for long term outcome.
Objective: Ninety-nine consecutive coiled SAH patients were included. Laboratory and clinical parameters as well as culture positive infections were followed over the disease course. Long-term outcome was assessed at 6-month by the Glasgow Outcome score (GOS) and dichotomized in favorable (GOS>3) and unfavorable outcome (GOS≤3). Results: The most frequent infections were pulmonary (30.3%) urinary tract (25.3%), blood stream infections (20.2%) and ventriculitis (5.1%). The incidence of infections did not significantly differ between outcome groups. In contrast, patients with unfavorable outcome had a higher incidence of sepsis (46.7% versus 24.6%). C-reactive protein (CRP) and leukocytes were significantly higher in patients with unfavorable outcome. A CRP increase of 6 mg/dl or more in the first 3 days after SAH was independently associated with unfavorable outcome (OR 7.19 CI 1.7-30.52; p=0.008). Patients with an early CRP increase were more frequently treated with antimicrobial therapy in the first 3 days after admission which led to a significantly lower incidence of culture positive infections in the later course. Conclusion: A sharp CRP-increase in the acute phase of SAH could potentially aid the intensivist in the early identification of patients at high risk for neurological morbidity. Early antimicrobial treatment reduces the rate of patients showing culture positive infections in the course of the disease.Export Options
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Cite this article as:
Nosocomial Infections and Antimicrobial Treatment in Coiled Patients with Aneurysmal Subarachnoid Hemorrhage, Current Drug Targets 2017; 18 (12) . https://dx.doi.org/10.2174/1389450117666160401124426
DOI https://dx.doi.org/10.2174/1389450117666160401124426 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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