Influencing factors and nursing strategies for prognosis of patients with septic shock in the intensive care unit
重症监护室脓毒症休克患者预后的影响因素及护理策略

摘要

目的 探讨ICU脓毒症休克患者预后影响因素及针对性护理策略效果，为改善预后提供参考。方法选取2024年10月至2025年10月本院ICU 44例脓毒症休克患者，随机分为对照组和实验组各22例。对照组常规护理，实验组在此基础采用基于预后影响因素的针对性护理。收集资料分析预后相关因素，比较两组ICU住院时间、总住院时间、28d存活率及护理前后APACHEⅡ、SOFA评分。结果 多因素Logistic回归显示，年龄≥60岁、APACHEⅡ评分≥25分、MODS、感染未有效控制是预后独立危险因素（P＜0.05）。实验组ICU住院时间（8.2±2.1）d、总住院时间（16.5±3.2）d，均短于对照组；28d存活率81.82%，高于对照组；护理后APACHEⅡ评分为（12.3±2.5）分、SOFA评分（5.1±1.3）分，均低于对照组，差异均有统计学意义（P＜0.05）。结论 年龄≥60岁、APACHEⅡ评分≥25分、MODS及感染未有效控制是主要危险因素；针对性护理能缩短住院时间，降低器官衰竭风险，提高28d存活率，改善预后。

Abstract

Objective This study investigates the prognostic factors and targeted nursing strategies for septic shock patients in the ICU, aiming to provide references for improving prognosis.
Methods A total of 44 septic shock patients admitted to the ICU of our hospital from October 2024 to October 2025 were selected and randomly divided into a control group and an experimental group, with 22 cases in each group. The control group received conventional nursing care, while the experimental group received targeted nursing based on prognostic factors. Data were collected and analyzed to evaluate prognostic-related factors, including ICU stay duration, total hospitalization duration, 28-day survival rate, and APACHE II and SOFA scores before and after nursing.
Results Multivariate logistic regression showed that age ≥60 years, APACHE II score ≥25, MODS, and uncontrolled infection were independent risk factors for poor prognosis (P<0.05). The ICU stay duration (8.2±2.1) days and total hospitalization duration (16.5±3.2) days in the experimental group were shorter than those in the control group. The 28-day survival rate was 81.82%, higher than that in the control group. The APACHE II score (12.3±2.5) and SOFA score (5.1±1.3) after nursing were lower than those in the control group, with statistically significant differences (P<0.05).
Conclusion   Age ≥60 years, APACHE II score ≥25, MODS, and uncontrolled infection are major risk factors. Targeted nursing can shorten hospitalization duration, reduce the risk of organ failure, improve 28-day survival rate, and enhance prognosis.