【摘要】 目的 探讨影响ICU患者病死率主要危险因素，以制定有效措施。 方法 对入住本院ICU超过48h的住院患者及入住ICU 48h内死亡的住院患者，进行为期2年的前瞻性监测。排除年龄<16岁的住院患者。结果 共监测276例病例，病死率为44.9%。99例(35.9%)发生医院感染。独立危险因素有平均年龄(HR 1.08，95%CI 0.98～1.15)、APACHE II评分(HR 2.01，95%CI 1.62～2.87)、机械通气(HR 1.87，95%CI 1.38～2.92)、医院感染(HR 0.41，95%CI 0.31～0.68)、鼻饲(HR 0.51，95%CI 0.32～0.69)、ICU住院天数(HR, 0.45; 95% CI, 0.24～0.60)、免疫抑制剂(HR 1.58，95%CI 1.18～2.09)、气管切开(HR 0.31，95%CI 0.01～0.69)。结论 ICU患者病死率独立危险因素有平均年龄、APACHE II评分、机械通气、医院感染、鼻饲、免疫抑制剂、气管切开。

    【关键词】 医院感染；危险因素；前瞻性研究

    Risk factors for mortality in intensive care units:a prospective study

    LIU Ying-xun , YU Bang-xu，SONG Lei ,et al.ICU Department, The Qingdao Chengyang Hospital , Qingdao 266109，China

    【Abstract】 Objective To investigate risk factors for mortality in intensive care units.Methods The prospective study was performed from January 2005 to November 2006 in ICU. 276 patients who were followed in the ICU for at least 48 hours were enrolled in this study. Those patients who died within 48 hours of ICU discharge were included in the mortality analysis.Results The overall mortality rate in the ICU was 44.9%. Among the 276 patients, 99 (35.9%) had nosocomial infections.The mean age, sex, acute physiology and chronic health evaluation (APACHE) II score, trauma and intraabdominal pathology, nosocomial infection, stay in ICU, coma, TISS score, use of steroid or chemotherapy, use of antibiotic were associated with mortality in the univariate analysis. Eight variables were determined as independent risk factors: mean age(HR 1.08 ......