Lavranou Georgia-Athanasia, Mentzelopoulos Spyros, Katsaounou Paraskevi, Siempos Ilias, Kalomenidis Ioannis, Geranaki Aikaterini, Routsi Christina, Zakynthinos Spyros
First Department of Intensive Care Medicine, School of Medicine, National and Kapodistrian University of Athens, 'Evangelismos' Hospital, 45-47 Ipsilandou St, GR-10675 Athens, Greece.
Hematology Laboratory, 'Evangelismos' Hospital, 45-47 Ipsilandou St, GR-10675 Athens, Greece.
J Clin Med. 2021 Apr 7;10(8):1548. doi: 10.3390/jcm10081548.
Although coagulation disorders and immune/inflammatory response have been associated with the final outcome of patients with sepsis, their link with thetemporaryclinical deterioration or improvement of patients is unknown. We aimed to investigate this link. We prospectively included consecutive patients admitted to the intensive care unit (ICU) with a suspected diagnosis of infection and evaluated within the first 24 h from admission. Blood levels of many cytokines and inflammatory and coagulation factors were measured and their predictive value was assessed by calculating the Area Under the Receiver Operating Characteristic (AUROC) curves. Patients ( = 102) were allocated in five groups, i.e., sepsis ( = 14), severe sepsis ( = 17), septic shock ( = 28), Systemic Inflammatory Response Syndrome (SIRS) without infection ( = 17), and trauma/surgery without SIRS or infection ( = 26). In septic shock, coagulation factors FVII and FIX and Protein C had AUROCs 0.67-0.78. In severe sepsis, Antithrombin III, Protein C, C-reactive protein, Procalcitonin and Thrombopoietin had AUROCs 0.73-0.75. In sepsis, Tumor Necrosis Factor a, and Interleukins 1β and 10 had AUROCs 0.66-0.72. In patients admitted to the ICU with a suspected diagnosis of infection, coagulation factors and inhibitors, as well as cytokine and inflammatory marker levels, have substantial predictive value in distinct groups of septic patients.
尽管凝血功能障碍和免疫/炎症反应与脓毒症患者的最终结局相关，但其与患者暂时的临床恶化或改善之间的联系尚不清楚。我们旨在研究这种联系。我们前瞻性纳入了入住重症监护病房（ICU）且疑似感染的连续患者，并在入院后24小时内进行评估。检测了多种细胞因子、炎症因子和凝血因子的血药浓度，并通过计算受试者工作特征曲线下面积（AUROC）评估其预测价值。102例患者分为五组，即脓毒症组（14例）、严重脓毒症组（17例）、感染性休克组（28例）、无感染的全身炎症反应综合征（SIRS）组（17例）以及无SIRS或感染的创伤/手术组（26例）。在感染性休克中，凝血因子FVII、FIX和蛋白C的AUROC为0.67 - 0.78。在严重脓毒症中，抗凝血酶III、蛋白C、C反应蛋白、降钙素原和血小板生成素的AUROC为0.73 - 0.75。在脓毒症中，肿瘤坏死因子α、白细胞介素1β和10的AUROC为0.66 - 0.72。在疑似感染入住ICU的患者中，凝血因子和抑制剂以及细胞因子和炎症标志物水平在不同脓毒症患者组中具有显著的预测价值。
