Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study

Abstract Background The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. Methods Clinical data from patients diagnosed with urosepsis were retrospectively retrieved...

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Autores principales:	Ying Sheng, Wen-long Zheng, Qi-fang Shi, Bing-yu Zhang, Guang-yao Yang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Urosepsis Urinary tract infections Clinical characteristics Prognosis Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/e86cdf8faf6241e9a40839f7dea56fa2
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spelling	oai:doaj.org-article:e86cdf8faf6241e9a40839f7dea56fa22021-11-28T12:09:37ZClinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study10.1186/s12871-021-01520-51471-2253https://doaj.org/article/e86cdf8faf6241e9a40839f7dea56fa22021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01520-5https://doaj.org/toc/1471-2253Abstract Background The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. Methods Clinical data from patients diagnosed with urosepsis were retrospectively retrieved and analyzed from ICU in two regional medical centers from January 2015 to December 2019. Results Two hundred two patients were included in the subsequent analysis eventually, with an average age of 72.02 ± 9.66 years, 79.21% of the patients were female and the mortality rate of 15.84%.The proportion of patients with chronic underlying diseases such as diabetes and hypertension was relatively high (56.44, 49.50%, respectively), and the incidence of shock was also high (41.58%) correspondingly. The most common pathogen isolated was Escherichia coli (79.20%), of which the extended-spectrumβ-lactamases (ESBLs)(+) accounted for 42.57%. In multivariate analysis, the strongest predictors for death were mechanical ventilation (OR 7.260, 95% CI 2.200–23.963; P = 0.001),chronic kidney disease (CKD) (OR 5.140, 95% CI 1.596–16.550; P = 0.006), APACHE II score (OR 1.321, 95% CI 1.184–1.473; P < 0.001) and lactate (OR 1.258, 95% CI 1.037–1.527; P = 0.020). Both APACHE II score and lactate had the ideal predictive value, with the area under the ROC curve (AUC) of 0.858 and 0.805 respectively. Conclusion The patients with urosepsis were characterized by a higher proportion of female, older age, more percentage of comorbidities in this region, and patients with ESBLs (+) Escherichia coli infection were more prone to shock. Mechanical ventilation, comorbidity with CKD, APACHE II score and lactate were independent risk factors for death in urosepsis patient, but lactate level and APACHE II score had better predictive value for prognosis.Ying ShengWen-long ZhengQi-fang ShiBing-yu ZhangGuang-yao YangBMCarticleUrosepsisUrinary tract infectionsClinical characteristicsPrognosisAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Urosepsis Urinary tract infections Clinical characteristics Prognosis Anesthesiology RD78.3-87.3
spellingShingle	Urosepsis Urinary tract infections Clinical characteristics Prognosis Anesthesiology RD78.3-87.3 Ying Sheng Wen-long Zheng Qi-fang Shi Bing-yu Zhang Guang-yao Yang Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
description	Abstract Background The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. Methods Clinical data from patients diagnosed with urosepsis were retrospectively retrieved and analyzed from ICU in two regional medical centers from January 2015 to December 2019. Results Two hundred two patients were included in the subsequent analysis eventually, with an average age of 72.02 ± 9.66 years, 79.21% of the patients were female and the mortality rate of 15.84%.The proportion of patients with chronic underlying diseases such as diabetes and hypertension was relatively high (56.44, 49.50%, respectively), and the incidence of shock was also high (41.58%) correspondingly. The most common pathogen isolated was Escherichia coli (79.20%), of which the extended-spectrumβ-lactamases (ESBLs)(+) accounted for 42.57%. In multivariate analysis, the strongest predictors for death were mechanical ventilation (OR 7.260, 95% CI 2.200–23.963; P = 0.001),chronic kidney disease (CKD) (OR 5.140, 95% CI 1.596–16.550; P = 0.006), APACHE II score (OR 1.321, 95% CI 1.184–1.473; P < 0.001) and lactate (OR 1.258, 95% CI 1.037–1.527; P = 0.020). Both APACHE II score and lactate had the ideal predictive value, with the area under the ROC curve (AUC) of 0.858 and 0.805 respectively. Conclusion The patients with urosepsis were characterized by a higher proportion of female, older age, more percentage of comorbidities in this region, and patients with ESBLs (+) Escherichia coli infection were more prone to shock. Mechanical ventilation, comorbidity with CKD, APACHE II score and lactate were independent risk factors for death in urosepsis patient, but lactate level and APACHE II score had better predictive value for prognosis.
format	article
author	Ying Sheng Wen-long Zheng Qi-fang Shi Bing-yu Zhang Guang-yao Yang
author_facet	Ying Sheng Wen-long Zheng Qi-fang Shi Bing-yu Zhang Guang-yao Yang
author_sort	Ying Sheng
title	Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
title_short	Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
title_full	Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
title_fullStr	Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
title_full_unstemmed	Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study
title_sort	clinical characteristics and prognosis in patients with urosepsis from intensive care unit in shanghai, china: a retrospective bi-centre study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e86cdf8faf6241e9a40839f7dea56fa2
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Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study

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