SOFA 评分联合 miR-150 预测脓毒症患者预后
Prediction of prognosis in sepsis patients by the SOFA score combined with miR-150.
机构信息
Department of Critical Care Medicine, Central Hospital of Jiangjin District, Chongqing, China.
Department of Medical Administration, Central Hospital of Jiangjin District, Chongqing, China.
出版信息
Adv Clin Exp Med. 2022 Jan;31(1):9-15. doi: 10.17219/acem/142536.
BACKGROUND
The sequential organ failure assessment (SOFA) score, designed to evaluate sepsis-associated organ dysfunction in intensive care unit (ICU) patients, is associated with the prognosis of sepsis patients. MicroRNA-150 (miR-150) is one of the first miRs to be detected in patients with sepsis and other critical illnesses, and to have an association with the prognosis of critical illness and sepsis.
OBJECTIVES
To assess the predictive value of the combination of the SOFA score and miR-150 levels for the prognosis of sepsis patients.
MATERIAL AND METHODS
We retrospectively included 437 adult patients with sepsis who were divided into a death group (n = 138, 31.6%) and a survival group (n = 299, 68.4%), according to their survival status at the 28-day follow-up. Binary logistic regression was performed to identify independent associations. Receiver operator characteristic (ROC) curve was employed to assess the predictive values. The Z-test was used to compare the area under curve (AUC).
RESULTS
Multivariate analysis demonstrated that miR-150 (odds ratio (OR): 0.549, 95% confidence interval (95% CI) [0.372, 0.826], p < 0.001), the SOFA score (OR: 1.216, 95% CI [1.039, 1.807], p = 0.008), age, procalcitonin (PCT), and septic shock were independently associated with 28-day mortality of sepsis patients following the adjustment for chronic renal failure, hypertension, diabetes mellitus, activated partial thromboplastin time (APTT), serum creatinine (SCr), blood urea nitrogen (BUN), and total bilirubin (TBil). The AUC of miR-150, the SOFA score and their combination in predicting the 28-day mortality of sepsis patients was 0.762 (standard error (SE): 0.023, 95% CI [0.717, 0.808]), 0.735 (SE: 0.025, 95% CI [0.687, 0.784]) and 0.886 (SE: 0.015, 95% CI [0.857, 0.916]), respectively. The AUC of their combined prediction was significantly greater than the independent prediction (0.886 compared to 0.762, Z = 4.516, p < 0.001; 0.886 compared to 0.735, Z = 5.179, p < 0.001). The sensitivity and specificity of combination prediction were 86.2% and 80.6%, respectively.
CONCLUSIONS
The combination of the SOFA score and miR-150 could improve the prediction of prognosis in sepsis patients.
背景
序贯器官衰竭评估 (SOFA) 评分旨在评估重症监护病房 (ICU) 中脓毒症相关的器官功能障碍，与脓毒症患者的预后相关。微小 RNA-150 (miR-150) 是最早在脓毒症和其他危重病患者中检测到的 miR 之一，与危重病和脓毒症的预后有关。
目的
评估 SOFA 评分和 miR-150 水平联合对脓毒症患者预后的预测价值。
材料和方法
我们回顾性纳入了 437 名成年脓毒症患者，根据 28 天随访时的生存状况，将其分为死亡组 (n = 138，31.6%) 和存活组 (n = 299，68.4%)。采用二元逻辑回归分析识别独立关联。采用受试者工作特征 (ROC) 曲线评估预测价值。采用 Z 检验比较曲线下面积 (AUC)。
结果
多变量分析表明，miR-150 (比值比 (OR)：0.549，95%置信区间 (95%CI) [0.372, 0.826]，p < 0.001)、SOFA 评分 (OR：1.216，95%CI [1.039, 1.807]，p = 0.008)、年龄、降钙素原 (PCT) 和脓毒性休克与慢性肾衰竭、高血压、糖尿病、活化部分凝血活酶时间 (APTT)、血清肌酐 (SCr)、血尿素氮 (BUN) 和总胆红素 (TBil) 校正后的脓毒症患者 28 天死亡率独立相关。miR-150、SOFA 评分及其组合预测脓毒症患者 28 天死亡率的 AUC 分别为 0.762 (标准误 (SE)：0.023，95%CI [0.717, 0.808])、0.735 (SE：0.025，95%CI [0.687, 0.784]) 和 0.886 (SE：0.015，95%CI [0.857, 0.916])。联合预测的 AUC 明显大于独立预测 (0.886 与 0.762，Z = 4.516，p < 0.001；0.886 与 0.735，Z = 5.179，p < 0.001)。联合预测的灵敏度和特异性分别为 86.2%和 80.6%。
结论
SOFA 评分和 miR-150 的联合可以提高脓毒症患者预后的预测能力。
Zotero 插件