フルテキストファイル
著者
Sejima Takehiro Department of Urology, Matsue-city Hospital
眞砂 俊彦 Department of Urology, Matsue-city Hospital
森實 修一 Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
本田 正史 Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
武中 篤 Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
キーワード
sepsis
urinary tract infection
urosepsis
抄録
Background: Urosepsis is an acute life-threating disease, and some cases show refractory outcome to therapy. In an aging society of developed countries, characteristics of urosepsis are becoming complicated. We performed a comprehensive investigation regarding the clinical and social aspects that are related to refractory outcomes in urosepsis patients. Methods: The patient cohort consisted of 66 patients with urosepsis. Multiple factors from clinical and social aspects were reviewed retrospectively. Two categories of refractory outcomes were defined. One was afebrile resistance (AR); fever continued more than 7 days from the initiation of therapy. Another was discharge resistance (DR); hospitalization continued for more than 30 days. Logistic regression analyses were performed to identify significant factors that are related to the AR or DR. Results: Univariate analysis demonstrated that high score of Eastern Cooperative Oncology Group Performance Status (ECOG PS) (? 2) and Age-adjusted Charlson comorbidity index (CCI) (? 4), high serum C-reactive protein (CRP) level (? 14.9 mg/dL), and low serum albumin level (? 2.26 g/dL) were significantly related to AR. Univariate analysis results also revealed that high score of ECOG PS (? 2), high serum creatinine level (? 1.54 mg/dL) and vasopressor administration were significantly related to DR. Multivariate analyses demonstrated that low serum albumin level (? 2.26g/dL) was the only significant factor that was related to AR. In contrast, high score of ECOG PS (? 2) and high serum creatinine level (? 1.54 mg/dL) were significant factors that were related to DR. Conclusion: It is suggested that evaluating serum albumin levels is essential for the therapeutic first step because hypoalbuminemia was the significant factor that was related to obstruction to antipyresis. It is also suggested that the deterioration of patients’ activities of daily living and renal dysfunction might be the refractory factors for discharge from the hospital, which was the ultimate therapeutic goal.
出版者
Tottori University Medical Press
資料タイプ
学術雑誌論文
外部リンク
ISSN
05135710
EISSN
13468049
書誌ID
AA00892882
掲載誌名
Yonago Acta Medica
最新掲載誌名
Yonago Acta Medica
65
3
開始ページ
254
終了ページ
261
発行日
2022-08-29
出版者DOI
著者版フラグ
出版社版
著作権表記
(C) 2022 Tottori University Medical Press.
掲載情報
Yonago Acta Medica. 2022, 65(3), 254-261. doi10.33160/yam.2022.08.012
部局名
医学部・医学系研究科・医学部附属病院
言語
英語