MỘT SỐ YẾU TỐ TIÊN LƯỢNG TỬ VONG TẠI NGÀY THỨ 28 TRÊN BỆNH NHÂN SỐC NHIỄM KHUẨN

Abstract

Objectives: Septic shock is one of the leading causes of death and disability in intensive care units with a pathophysiological disorder characterized by multi-organ dysfunction caused by body respond to infection, so that predicting the risk of mortality was an important role in making treatment decisions. This study aims to evaluate the ability of some factors to predict mortality at day 28 in patients with septic shock. Methods: A cross-sectional description study, data was collected on  200 patients diagnosed with septic shock and treated at the Intensive Care Center of Bach Mai Hospital during the period from August 2022 to July 2023. Results: A 200-patients study with the ratio male/female: 2:1, mean age: 58.27 ± 18.42, the common classfication of age is 60-80 years old. The most common cause of septic shock was respiratory infection (51%) and has no diffirece about mortality rate in each causes. The mean albumin concentration: 26.3 ± 5.85 g/l (11.3- 45.6 g/l), SOFA score median: 11 (min:4, max: 20), APACHE II median: 18 (min: 3, max: 47), the median Pro-calciton concentration: 25,15 (min:0,324 – max:100), the median Lactat concentration: 3 (min:0,7 – max:20). SOFA score and APACHE II score have the ability to predict mortality on day 28 with AUC: 0.683 and 0.706. The concentration pro-calcitonin and lactate were less likely to predict mortality with AUC: 0.557 and 0.623. Albumin's ability to predict death on day 28 is low with AUC: 0.369, however the albumin concentration less than 25g/l is a risk factor for death with OR alive/dead: 0.425, p<0.05. Conclusion: The SOFA SCORES and APACHE II SCORES are both capable of predicting death at day 28 in septic shock, and the pro-calcitonium concentration and lactate concentration are capable of lower-level predicting. The albumin concentration was not predict mortality at day 28. The low albumin concentration is a prognostic factor in treatment.