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Zhonghua Nei Ke Za Zhi ; 55(12): 941-944, 2016 Dec 01.
Artículo en Chino | MEDLINE | ID: mdl-27916049

RESUMEN

Objective: To study the clinical characteristics and prognosis of patients with persistent inflammation immunosuppression and catabolism syndrome (PICS) in ICU. Methods: A total of 126 patients admitted to ICU (ICU stay of more than 10 days, age≥18 years) between January 2014 to December 2014 were retrospectively studied.Data were collected from electronic medical records including demographics, underlying disease, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment (SOFA) score, laboratory parameters, ICU acquired infections and clinical outcome. Results: The overall incidence of PICS in ICU patients (ICU stay of more than 10 days) was 50.0%(63/126). There were no significant differences in baseline data such as gender, age, APACHEⅡscore, SOFA score and underlying diseases between the two groups(all P>0.05). Compared with the non-PICS group, there were more patients with gastrointestinal perforation in the PICS group (P=0.042), however, the medical or surgical admission did not differ between the two groups(P>0.05). During the stay in ICU, the PICS group showed a higher risk of developing acquired infections compared with the non-PICS group[PICS 63.5%(40/63) vs non-PICS 23.8%(15/63); P<0.001]. The infections were more caused by Candida in the PICS group than the non-PICS group [PICS 22.4%(11/49) vs non-PICS 2/17; P=0.003]. Moreover, the PICS group experienced longer stay in ICU[PICS(31.6±28.8) days vs non-PICS (20.4±11.3) days; P=0.0046] and higher ICU mortality [PICS 28.6%(18/63) vs non-PICS 6.3%(4/63), P=0.001]. Conclusion: PICS is a common manifestation of patients who stay in ICU more than 10 days, which is associated with high risk of ICU acquired infections, prolonged length of stay and high mortality.


Asunto(s)
Cuidados Críticos/métodos , Terapia de Inmunosupresión , Inflamación/etiología , Unidades de Cuidados Intensivos , Insuficiencia Multiorgánica/diagnóstico , APACHE , Adolescente , Adulto , Anciano , Femenino , Mortalidad Hospitalaria , Humanos , Terapia de Inmunosupresión/métodos , Incidencia , Inflamación/complicaciones , Inflamación/epidemiología , Inflamación/mortalidad , Tiempo de Internación/estadística & datos numéricos , Masculino , Metabolismo , Persona de Mediana Edad , Insuficiencia Multiorgánica/clasificación , Insuficiencia Multiorgánica/mortalidad , Pronóstico , Estudios Retrospectivos , Síndrome
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