Objective To analyze the prognostic factors in the postoperative patients with prolonged mechanical ventilation after extracorporeal circulation.Methods From Oct 2004 to Oct 2007，35 cases of postoperative patients after extracorporeal circulation required mechanical ventilation for ≥24 hours in ICU were enrolled.The patients were divided into death group and survival group.Preoperative variables including blood glucose，serum albumin，creatinine and ejection fraction（EF），intra-operative variables such as cardiopulmonary bypass（CPB） duration，aortic cross clamp（ACC） time，blood transfusion，and postoperative variables such as vital sign arrival at ICU，renal function，drainage in first 24 hours，APACHEⅡ score，ventilation duration were analyzed retrospectively.Results There were significant differences in blood glucose，serum albumin，EF，CPB，ACC，fresh frozen plasma transfusion，APACHEⅡ，creatinine，APTT and oxygenation index between the death group（12 cases，34.29%） and the survival group（23 cases，65.71%）.Stepwise logistic regression analysis indicated that EF（OR=0.7973，95%CI 0.6417-0.9906） and APACHEⅡ（OR=1.8588，95%CI 1.1071-3.1210） were predictors of prognosis.Conclusions High mortality is found in postoperative patients after extracorporeal circulation with prolonged mechanical ventilation.The main predictors of prognosis were EF and APACHEⅡ.It’s important to assess preoperative condition for cardiac surgical patients completely and provide more intensive perioperative care.
Objective To explore the distribution characteristics and prognostic risk factors of critically ill patients who has long-term hospitalization in intensive care unit ( ICU) . Methods A retrospective study was carried out to evaluate 119 critically ill patients from January 2003 to July 2009 by extracting data from computerized hospital information system. The patients were divided into a survival group and a non-survival group based on discharging outcomes. A binary logistic regression analysis wasintroduced to investigate potential risk factors of prognosis. Results Age, type of payment, entity of disease,and length of ICU stay were significantly different between the two groups ( P lt; 0. 05) in independent-Samples T test. Logistic regressions indicated that age, length of ICU stay and plasma infusion were independent predictors for worse outcome. Conclusions Age, length of ICU stay and plasma infusion may directly influence the prognosis of patients with prolonged stay in ICU. Intensive therapies should be emphasized for those patients at high risk.
Objective To investigate the prognostic factors and hospitalization cost in patients diagnosed as central line-associated bloodstream infection( CLABSI) in intensive care unit( ICU) .Methods A retrospective study was made to investigate the CLABSI epidemic data in ICU from June 2006 to June 2009. Clinical and physiological parameters were summarized and compared between these patients, which were divided into two groups based on the clinical outcome. Meanwhile, events including blood transfusion,mechanical ventilation, as well as cost of hospitalization were also reviewed. Logistic regression method was introduced to investigate the potential prognostic risk factors. Results There were 49 patients were diagnosed as nosocomial CLABSI, in which 19 cases( 38. 8% ) died in the hospital and 30( 61. 2% ) weresurvival. In univariate analysis, differences in body temperature, central venous pressure, acute physiology and chronic health evaluation( APACHEⅡ ) score, blood transfusion amount, pH value, D-dimer, blood serum alanine transarninase, blood urea nitrogen level, serumcreatinine, serumpotassiumbetween the survivors andthe non-survivors were significant( P lt;0. 05) . However, no significant differences were observed between the two groups in in-hospital days, ICU days and hospitalization cost ( all P gt; 0. 05) . With multiple logistic regressions, higher APACHEⅡ score( OR 0. 78; 95% confidence interval: 0. 66-0. 94; P = 0. 007) , APTTlevel( OR 0. 87; 95% confidence interval: 0. 77-0. 98; P = 0. 026) and serum potassium( OR 0. 09; 95% confidence interval: 0. 01-0. 80; P = 0. 031) were independent predictors of worse outcome. Conclusions Disease severity and coagulation situation may directly predict the prognosis of nosocomial CLABSI patients.But current investigation did not demonstrate significant differences in ICU length of stay and respective cost between the CLABSI patients with different prognosis.