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学科主题: 临床医学
题名:
Impact of invasive fungal infection on outcomes of severe sepsis: a multicenter matched cohort study in critically ill surgical patients
作者: Xie, Guo-Hao1,2; Fang, Xiang-Ming1,2; Fang, Qiang1,2; Wu, Xin-Min3,4; Jin, Yu-Hong5; Wang, Jun-Lu6; Guo, Qu-Lian7,8; Gu, Miao-Ning9,10; Xu, Qiu-Ping11,12; Wang, Dong-Xin3,4; Yao, Shang-Long13,14; Yuan, Shi-Ying13,14; Du, Zhao-Hui15; Sun, Yun-Bo16,17; Wang, Hai-Hong11,12; Wu, Shui-Jing1,2; Cheng, Bao-Li1,2
刊名: CRITICAL CARE
发表日期: 2008
DOI: 10.1186/cc6766
卷: 12, 期:1
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Critical Care Medicine
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: INTENSIVE-CARE UNITS ; BLOOD-STREAM INFECTIONS ; RISK-FACTORS ; SEPTIC SHOCK ; ICU PATIENTS ; EPIDEMIOLOGY ; CANDIDEMIA ; MORTALITY ; STATES ; SUSCEPTIBILITY
英文摘要:

Introduction Fungal infection is increasingly common in critical illness with severe sepsis, but the influence of invasive fungal infection ( IFI) on severe sepsis is not well understood. The aim of this study was to investigate the impact that IFI has on the outcomes of critically ill surgical patients with severe sepsis in China by means of matched cohort analysis; we also evaluated the epidemiologic characteristics of IFI in this population.

Methods Records for all admissions to 10 university hospital surgical intensive care units ( ICUs) from December 2004 to November 2005 were reviewed. Patients who met criteria for severe sepsis were included. IFI was identified using established criteria based on microbiologic or histological evidence. A matched cohort study was conducted to analyze the relationship between IFI and outcomes of severe sepsis.

Results A total of 318 patients with severe sepsis were enrolled during the study period, of whom 90 ( 28.3%) were identified as having IFI. A total of 100 strains of fungi ( 58% Candida albicans) were isolated from these patients. Independent risk factors for IFI in patients with severe sepsis included mechanical ventilation (> 3 days), Acute Physiology and Chronic Health Evaluation score, coexisting infection with both Gram-positive and Gram-negative bacteria, and urethral catheterization (> 3 days). Compared with the control cohort, IFI was associated with increased hospital mortality ( P < 0.001), high hospital costs ( P = 0.038), and prolonged stay in the ICU ( P < 0.001) and hospital ( P = 0.020).

Conclusion IFI is frequent in patients with severe sepsis in surgical ICUs and is associated with excess risk for hospital mortality, longer ICU and hospital stays, and greater consumption of medical resources.

语种: 英语
WOS记录号: WOS:000254812500045
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/63357
Appears in Collections:北京大学第一临床医学院_麻醉科_期刊论文

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作者单位: 1.Zhejiang Univ, First Affiliated Hosp, Sch Med, Dept Anesthesiol, Hangzhou 310003, Peoples R China
2.Zhejiang Univ, First Affiliated Hosp, Sch Med, Intens Care Unit, Hangzhou 310003, Peoples R China
3.Peking Univ, First Affiliated Hosp, Sch Med, Dept Anesthesiol, Beijing 100034, Peoples R China
4.Peking Univ, First Affiliated Hosp, Sch Med, Intens Care Unit, Beijing 100034, Peoples R China
5.Ningbo Univ, Lihuili Hosp, Sch Med, Intens Care Unit, Ningbo 315040, Peoples R China
6.First Affiliated Hosp, Wenzhou Med Coll, Dept Anesthesiol, Wenzhou 325000, Peoples R China
7.Cent S Univ, Xiangya Med Coll, Xiangya Hosp, Dept Anesthesiol, Changsha 410008, Peoples R China
8.Cent S Univ, Xiangya Med Coll, Xiangya Hosp, Intens Care Unit, Changsha 410008, Peoples R China
9.S Med Univ, South Hosp, Dept Anesthesiol, Guangzhou 510515, Peoples R China
10.S Med Univ, South Hosp, Intens Care Unit, Guangzhou 510515, Peoples R China
11.Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Anesthesiol, Hangzhou 310016, Peoples R China
12.Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Intens Care Unit, Hangzhou 310016, Peoples R China
13.Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Dept Anesthesiol, Wuhan 430030, Peoples R China
14.Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Intens Care Unit, Wuhan 430030, Peoples R China
15.Wuhan Univ, Zhongnan Hosp, Sch Med, Intens Care Unit, Wuhan 430071, Peoples R China
16.Qingdao Univ, Qingdao Univ Hosp, Sch Med, Dept Anesthesiol, Qingdao 266011, Peoples R China
17.Qingdao Univ, Qingdao Univ Hosp, Sch Med, Intens Care Unit, Qingdao 266011, Peoples R China

Recommended Citation:
Xie, Guo-Hao,Fang, Xiang-Ming,Fang, Qiang,et al. Impact of invasive fungal infection on outcomes of severe sepsis: a multicenter matched cohort study in critically ill surgical patients[J]. CRITICAL CARE,2008,12(1).
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