- 期刊
The Role of APACHE Scores in Predicting Nosocomial Infections for Patients with Blunt Trauma
APACHE記分法在預測鈍性外傷病人發生院內感染所扮演之角色
摘要
院內感染常造成醫院內之併發症及死亡。本篇文章之目的在於探討APACHE Ⅱ, Ⅲ及Injury Severity Scale (ISS)是否可以當作腹部創傷後，住入加護病房之病人發生院內感染之獨立預測因子。 本論文係選擇了299個因腹部鈍傷而住入加護病房之病人來做分析，病人之基本資料及發生何種院內感染均加以記載，用多變數回歸分析法以決定看何種變數會是發生院內感染之因子。結果發現年齡、是否有插氣管內管、住加護病房之期間、APACHE score和ISS，均與感染之發生有關。然而，只有住加護病房之期間是發生院內感染之獨立預測因子，其他變數則否。而APACHE Ⅱ, Ⅲ和ISS score其實與住加護病房之期間有線性相關，但如果是針對院內感染肺炎而言，則年齡、是否有插氣管內管及住加護病房之時間均是獨立之預測因子。 結論則可以說APACHE Ⅱ, Ⅲ和ISS score對腹部鈍傷之病人住入加護病房後是否發生院內感染，並非良好之預測因子，但這些計分法和住加護病房之期間有相關性。未來對某些病人再做細分類，應可找出產生院內感染之預測因子。
關鍵字
無資料並列摘要
Objective: Nosocomial infections contribute to hospital-associated morbidity and mortality. The aim of this study is to identify the role of the Acute Physiology And Chronic Health Evaluation (APACHE) II, III and Injury Severity Scale (ISS) as independent predictors of nosocomial infections in blunt trauma patients admitted to the intensive care unit (ICU). Methods: A retrospective chart review of 299 blunt trauma patients admitted to the ICU was conducted by one trauma surgeon. Demographic data and incidence of nosocomial infections were recorded. Multivariate logistic regression analysis was used to determine variables that were predictors of the occurrence of nosocomial infections. Results: Age, presence of intubation, ICU length of stay, APACHE II, III and ISS were related to the presence of nosocomial infections. However, only the ICU length of stay was an independent predictor of a nosocomial infection, with an odd ratio of 1.16 (95% confidential interval 1.10~1.22). APACHE II, III and ISS scores were linearly correlated with length of ICU stay. Age, presence of endotracheal intubation and length of ICU stay became independent predictors when the infections were focused on nosocomial pneumonia. Conclusions: APACHE II, III and ISS scores were not good predictors of nosocomial infections in blunt trauma patients admitted to the ICU, but these scores have modest correlations with the duration of stay in ICU.
延伸閱讀
- Lee, K. H., Chen, M. Y., Huang, T. T., Huang, J. S., Wong, T. Y., & Chen, K. C. (2018). 錐狀射源電腦斷層判斷牙齦鱗狀細胞癌骨侵犯範圍－病例報告. 臺灣口腔顎面外科學會雜誌, 29(3), 218-229. https://www.airitilibrary.com/Article/Detail?DocID=a0000494-201809-201810110019-201810110019-218-229
- Tsai, F. C. (2020). 小兒外傷住院患者其嚴重度及受傷型態與成人之差異，及小兒嚴重外傷之早期預測因子—高雄醫學大學附設醫院八年經驗的回溯性橫斷式分析 [master's thesis, Kaohsiung Medical University]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0011-1507202009522300
- 李璧伊、黃建元、王建楠（2008）。南部某醫學中心尖銳物品扎傷發生率及其相關因素之探討。中華職業醫學雜誌，15(1)，43-53。https://doi.org/10.30027/CJOM.200801.0004
- Tan, W. C., & Huang, C. F. (2006). 運用立體定位技術治療腦幼裂頭絛蟲病：病例報告. 中山醫學雜誌, 17(2), 263-268. https://doi.org/10.30096/CSMJ.200612.0011
- 曾櫻枝、鄭綺、盧美秀、蔡瑞章（2000）。開顱手術病患急性混亂相關因素及定義性特徵之臨床效度測定。新臺北護理期刊，2(2)，55-67。https://doi.org/10.6540/NTJN.2000.2.006