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    標題: Risk Factors for Development of Septic Shock in Patients with Urinary Tract Infection
    作者: Hsiao, Chih-Yen
    Yang, Huang-Yu
    Chang, Chih-Hsiang
    Lin, Hsing-Lin
    Wu, Chao-Yi
    Hsiao, Meng-Chang
    Hung, Peir-Haur
    Liu, Su-Hsun
    Weng, Cheng-Hao
    Lee, Cheng-Chia
    Yen, Tzung-Hai
    Chen, Yung-Chang
    Wu, Tzu-Chin
    貢獻者: 醫務管理系
    生活應用與保健系
    關鍵字: Acute-renal-failure
    Acute kidney injury
    Acute pyelonephritis
    Severe sepsis
    Cardiac dysfunction
    Epidemiology
    Multicenter
    Management
    Mechanisms
    Mortality
    日期: 2015
    上傳時間: 2016-04-19 19:00:35 (UTC+8)
    出版者: Hindawi Publishing Corporation
    摘要: Introduction. Severe sepsis and septic shock are associated with substantial mortality. However, few studies have assessed the risk of septic shock among patients who suffered from urinary tract infection (UTI). Materials and Methods. This retrospective study recruited UTI cases from an acute care hospital between January 2006 and October 2012 with prospective data collection. Results. Of the 710 participants admitted for UTI, 80 patients (11.3%) had septic shock. The rate of bacteremia is 27.9%; acute kidney injury is 12.7%, and the mortality rate is 0.28%. Multivariable logistic regression analyses indicated that coronary artery disease (CAD) (OR: 2.521, 95% CI: 1.129-5.628, P = 0.024), congestive heart failure (CHF) (OR: 4.638, 95% CI: 1.908-11.273, P = 0.001), and acute kidney injury (AKI) (OR: 2.992, 95% CI: 1.610-5.561, P = 0.001) were independently associated with septic shock in patients admitted with UTI. In addition, congestive heart failure (female, OR: 4.076, 95% CI: 1.355-12.262, P = 0.012; male, OR: 5.676, 95% CI: 1.103-29.220, P = 0.038, resp.) and AKI (female, OR: 2.995, 95% CI: 1.355-6.621, P = 0.007; male, OR: 3.359, 95% CI: 1.158-9.747, P = 0.026, resp.) were significantly associated with risk of septic shock in both gender groups. Conclusion. This study showed that patients with a medical history of CAD or CHF have a higher risk of shock when admitted for UTI treatment. AKI, a complication of UTI, was also associated with septic shock. Therefore, prompt and aggressive management is recommended for those with higher risks to prevent subsequent treatment failure in UTI patients.
    關聯: Biomed Research International, v.2015, Article ID 717094
    顯示於類別:[醫務管理系(所)] 期刊論文
    [生活保健科技系] 期刊論文

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