Multivariate Aanlysis for Prognostic Factors of Nosocomial Infection in Severe Liver Diseases / 中国医师杂志

Objective To explore the prognostic factors of nosocomial infection in severe hepatitis and liver cirrhosis,and to assess its prevention and treatment.Methods A prospective study of nosocomial infection of severe hepatitis and liver cirrhosis was carried out in our hospital from Apr.1996 to Dec.2000.The prognostic factors of nosocomial infection in severe liver diseases was analyzed by logistic regression.Results The mortality of nosocomial infection in severe liver was 37 36%(34/91).Multiple regression analysis showed that prognosis was in order variables related to follow factors:Serum bilirubin,prothrombin time,complement C3,serum cholesterol,serum sodium,white blood cells count,polymorphonuclear cell rate,the kinds of nosocomial infection,severe complications and improper medical manipulations.The prognostic factors high correlated with nosocomial infection via analysis by logistic analysis were as follows:low serum complement C3 and low cholesterol.Conclusions The nosocomial infection were important factors that cause highly mortality in severe liver diseases.The prognositic factors high related with nosocomial infection of severe liver diseases were:low serum complement C3 and cholesterol level.

Clinical Characteristics of Hypernatremia / 대한신장학회잡지

Hypematremia is a rare but important medical condition and is associated with mortality rate of 40 to 70%. However, little has been known about its prognostic factors or treatment guidlines. To evaluate the prognostic factors and the outcome following treatment, we reviewed 22 available medical records among twenty five hypernatremic patients (0.2%) in 12841 admissions at medical ward from January to December 1995. We defined hypernatremia as serum sodium concentration more than or equal to 150 mEq/L. Of these patients, two had hypematrernia at admission and the remaining patients became hypernatremic during admission. Mean peak serum sodium concentration was 158 (150-178) mEq/L and mean total body water deficit was 11.4 (6.7-21.3)%. Factors correlated with the development of hypernatremia were diverse and multiple, and the most frequent factor was diminished access to water. Mortality rate was 59%, but mortality was not correlated with age, correction rate of hyper-natremia, primary route of fluid loss, and the severity of hypernatremia or total body water deficit. Mortality rate was higher in patients whose serum sodium concentrations were below 130 mEq/L at admission (P<0.05). In our study, development of hypernatremia from initial hyponatremic state was significantly associated with poor outcome, and age, rapidity of correction, route of fluid loss, and the severity of hypernatremia or total body water deficit were not.