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균혈증을 동반한 지역사회획득 중증패혈증환자의 예후인자: 전향 적, 관찰연구

Other Titles
 Prognostic Factors of Community-acquired Bacteremic Patients with Severe sepsis: A Prospective, Observational Study. 
Authors
 윤영경 ; 김민자 ; 박대원 ; 권순선 ; 천병철 ; 정희진 ; 최준용 ; 최희정 ; 최영화 ; 김효열 ; 엄중식 ; 김상일 ; 송영구 ; 백경란 ; 김양수 ; 김준명 ;  손장욱 
Citation
 Infection and Chemotherapy, Vol.44(3) : 168~174, 2012 
Journal Title
 Infection and Chemotherapy 
ISSN
 2093-2340 
Issue Date
2012
Abstract
BACKGROUND: Characterization of clinical features of bacteremic severe sepsis acquired from the community has been inadequate; therefore, our goal in this study was to identify prognostic factors associated with outcome in patients with community-acquired bacteremic severe sepsis. MATERIALS AND METHODS: Adult patients (> or =18 years) with community-acquired severe sepsis in whom pathogens were identified from blood cultures were included in the study. Data were collected prospectively from 12 teaching hospitals between May, 2005, and February, 2009. Data included demographic characteristics, co-morbid medical conditions, primary infection sites, sepsis severity, mortality, causative microorganisms, and the appropriateness of initial empirical antibiotic therapy. RESULTS: During the study period, 1,152 patients were diagnosed with community-acquired severe sepsis and 422 patients were found to harbor pathogens in their blood. Among the 422 patients analyzed, 253 (60.0%) patients went into shock and 121 patients (28.7%) died during hospitalization. Risk factors, including respiratory tract infection (odds ratio [OR], 2.60; 95% confidence interval [CI], 1.11-6.09), number of organ dysfunctions (OR, 1.39; 95% CI, 1.13-1.71), and higher APACHE II scores (OR, 1.08; 95% CI, 1.03-1.13) showed an association with poor survival, whereas Escherichia coli as a pathogen (OR, 0.31; 95% CI, 0.16-0.64) showed an association with lower mortality. CONCLUSIONS: In addition to severity of illness, the primary site of infection and causative microorganisms were also identified as important prognostic factors in patients with community-acquired bacteremic severe sepsis.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/90399
DOI
10.3947/ic.2012.44.3.168
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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