To explore the high risk factors affecting the prognosis of patients with severe sepsis or septic shock by analyzing the clinical data, the distribution of pathogenic bacteria and other biochemical indicators of these patients.

A total of 1 013 patients with severe sepsis/septic shock admitted to our hospital from December 2004 to December 2014 were selected as the research objects. General data, physiological and chronic health score Ⅱ (APACHE Ⅱ), infection site, pathogenic bacteria and biochemical indicators were recorded. According to the prognosis, the patients were divided into survival group 562 cases and death group 451 cases. Logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of the patients.

Compared with the survival group, the age(59.62±11.21 vs. 46.32±9.46) , APACHEⅡ score (25.26±8.75 vs. 13.67±6.57) and the proportion of septic shock (54.99% vs. 27.22%)of the patients in the death group increased significantly (P<0.05). The levels of serum albumin and platelet count of the patients in the survival group were significantly higher than that in the death group (P<0.05), and the levels of procalcitonin and blood lactic acid were significantly lower than that in the death group (P<0.05). Respiratory infection rate (35.05% vs. 36.59%) and G-bacteria infection rate (46.44% vs. 63.64%) were the highest in the second group. Age, APACHEⅡ score, blood lactic acid, and procalcitonin were negatively correlated with the prognosis of patients with severe sepsis (r=0.359, -0.876, -0.582, -0.821, P<0.05). Serum albumin was positively correlated with the prognosis of patients with severe sepsis (r=0.637, P<0.05). Age+ APACHEⅡ+ blood lactic acid+ procalcitonin+ serum albumin combined detection has higher predictive value for death of severe sepsis/septic shock patients (AUC=0.981).

Age, APACHEⅡ score, serum lactic acid, procalcitonin and serum albumin are independent risk factors affecting the prognosis of patients with severe sepsis/septic shock, which have important clinical value for early prediction and effective improvement of the prognosis of patients with severe sepsis/septic shock.