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Objective To investigate clinical characteristics of elderly patients with sepsis combined with congestive heart failure and risk factors for short-term mortality.Methods Clinical data of elderly patients with sepsis combined with congestive heart failure who were admitted in our hospital from January 2013 to January 2018 were selected and retrospectively analyzed.They were divided into the survival group(n=134)and the death group(n=83)according to survival status during hospitalization.The clinical characteristics and risk factors for mortality were analyzed and compared.Results A total of 217 elderly patients were enrolled,with 113 males and a mean age of(72.3 ± 7.5)years.The death rate of sepsis was 38.3％ (83/217 cases),and 29 cases died of sepsis and 54 cases died of other diseases.Pneumonia accounted for 78.8％ (171/217 patients) in all patients of two groups,and skin and soft tissue infection for 12.9 ％ (28/217 cases).There were significant differences between two groups in age,body mass index,smoking,diabetes,chronic obstructive pulmonary disease,mean arterial pressure,arterial oxygen partial pressure(PaO2),C-reactive protein,white blood cell counts,neutrophil and lymphocyte counts,glomerular filtration rate,serum sodium level,albumin level,lactate level,and left ventricular ejection fraction(P ＜0.05).Furthermore,the rates of invasive mechanical ventilation and continuous renal replacement therapy were higher in the death group than in the survival group(x2=13.209 and 7.402,P＜0.001 and 0.007).Multivariate Cox regression analysis showed that advanced age,chronic obstructive pulmonary disease,low albumin level and low glomerular filtration rate were risk factors for mortality(P＜0.05).Conclusions Elderly patients with sepsis combined with congestive heart failure often have severe pneumonia and violent skin and soft tissue infection,with worse heart and renal function.Advanced age,chronic obstructive pulmonary disease,low albumin level and low glomerular filtration rate are risk factors for mortality.
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Objective To analyze the risk factors of postmyocardial infarction syndrome(PMIS)to female patients with acute coronary syndromes(ACS).Methods 258 female patients with ACS complicated with myocardial infarction were selected, of whom 24 patients with PMIS.The clinical data of the two groups were compared and made Logistic regression analysis with different factors to get independent risk factors for PMIS.Results Of 258 female patients with ACS complicated with myocardial infarction, 24 patients with PMIS, the proportion was 9.30%.The age, infarct size, fibrinogen(FIB) level, creatine kinase isoenzymes(CK-MB) level and troponin I(cTnI) level of PMIS group were (64.95±4.95)years old,(11.65±1.52)cm, (2,6.91±1.86)g/L,(36.91±2.46)ng/L,(8.91±1.54)ng/L,respectively, which were higher than those in non-PMIS group[(56.18±4.83)years old,(8.83±1.49)cm2,(5.41±1.58)g/L,(33.88±2.25)ng/L,(6.40±1.17)ng/L](t=8.452,8.814,4.354,6.229,9.695,all P＜0.05).The proportion of patients with smoking and drinking habits, proportion of patients with underlying diseases, proportion of patients with chronic pulmonary disease, proportion of patients with heart and stalk history, proportion of patients with Killip grade Ⅲ-Ⅳ were 16.67%,37.50%,20.83%,66.67%,66.67%,respectively,which were higher than those in non-PMIS group (4.70%,11.97%,8.97%,31.20%,31.20%, x2=5.692,11.553,4.378,12.120,7.172,all P＜0.05).Logistic regression analysis showed that basic disease, history of myocardial infarction, infarct size, Killip classification, CK-MB level and cTnI level were independent risk factors for PMIS.Conclusion The combination of basic disease, history of myocardial infarction, larger infarct size, higher Killip classification, high CK-MB level and high cTnI level can increase the risk of PMIS in female patients with ACS.
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Objective To investigate the impacts of health education on awareness of hyperglycemia,self-efficacy and serum level of blood glucose in patients with coronary heart disease (CHD).Methods Two hundred CHD patients were enrolled in this study and assigned to the normal blood glucose (NGT) group ( n =60),impaired glucose regulation (IGR) group ( n =50),and type 2 diabetes mellitus (T2DM) group (n =90).Health education programme was carried out before and after discharge from the hospital.Fasting plasma glucose (FPG),2 h postprandial blood glucose (2 hPG) and glycosylated hemoglobin ( HbA1c ) of each group were assessed at baseline and 3 or 6 months after the intervention.Chisquare or t test was used for data analysis.Results After the intervention,the awareness of hyperglycemia was significantly improved in each of three groups (NGT group:x2 values were 17.207,23.582,37.046,39.046,38.686,46.218,28.643,39.895,37.046 and 33.333,respectively,all P ＜ 0.05 ; IGR group:x2values were 31.723,23.529,23.389,27.542,21.091,27.307,20.219,38.235,24.669 and 26.475,respectively,all P ＜0.05; T2DM group:x2 values were 21.161,20.680,14.612,23.104,22.383,29.436,19.444,32.526,24.671 and 31.696,respectively,all P ＜ 0.05 ).Self-efficacy scores of symptom selfmanagement and common disease management were increased after the health education intervention (t values were 12.75 and 7.21,respectively,both P ＜ 0.05 ).At 3 or 6 months,the NGT group showed on significant change in FPG,2 h PG and HbAlc (F values were 2.35,1.97 and 2.01,respectively,all P ＞0.05) ; however,FPG,2 h PG and HbAlc of the IGR and T2DM group were significantly decreased ( IGRgroup:F values were 8.07,8.89,and 10.23,respectively,all P ＜ 0.05 ; T2DM group:F values were 12.35,11.56 and 8.99,respectively,all P ＜ 0.05 ).Conclusion Health education could improve the awareness of hyperglycemia,self-efficacy and glucose metabolism in patients with CHD.