老年脓毒症患者 PaO/FiO、SOFA 和 D-二聚体的预后价值。
Prognostic value of PaO/FiO, SOFA and D-dimer in elderly patients with sepsis.
机构信息
Department of pathophysiology, Jiaying University, Meizhou, Guangdong Province, China.
Department of Nursing, Jiaying University, Meizhou, Guangdong Province, China.
出版信息
J Int Med Res. 2022 Jun;50(6):3000605221100755. doi: 10.1177/03000605221100755.
OBJECTIVE
To investigate the prognostic value for predicting mortality of partial pressure of oxygen/fraction of inspired oxygen (PaO/FiO), the Sequential Organ Failure Assessment (SOFA) score and D-dimer in elderly patients with sepsis.
METHODS
This retrospective cohort study enrolled elderly patients with sepsis admitted to the intensive care unit (ICU) between January 2019 and October 2020. Patients were divided into a survival group and a non-survival group. Biomarkers, SOFA, Acute Physiology and Chronic Health Evaluation II and Glasgow Coma Scale scores were recorded within 24 h after admission to the ICU.
RESULTS
A total of 135 elderly patients with sepsis were enrolled in the study: 89 were in the survival group and 46 were in the non-survival group at 28 days. Univariate and multivariate regression analyses demonstrated that PaO/FiO, SOFA and D-dimer were independently associated with 28-day mortality. The predictive performance for mortality of the combination of PaO/FiO, SOFA score and D-dimer (area under the receiver operating characteristic curve of 0.926) was higher than the values for the individual factors (0.761, 0.745 and 0.878, respectively).
CONCLUSION
The combination of PaO/FiO, SOFA score and D-dimer represents a promising tool and biomarker for predicting 28-day mortality of the elderly patients with sepsis.
目的
探讨氧分压/吸入氧分数（PaO/FiO）、序贯器官衰竭评估（SOFA）评分和 D-二聚体对老年脓毒症患者死亡率的预测价值。
方法
本回顾性队列研究纳入了 2019 年 1 月至 2020 年 10 月入住重症监护病房（ICU）的老年脓毒症患者。患者分为存活组和未存活组。记录患者入住 ICU 24 小时内的生物标志物、SOFA、急性生理学与慢性健康评估 II 评分和格拉斯哥昏迷量表评分。
结果
本研究共纳入 135 例老年脓毒症患者：28 天存活 89 例，死亡 46 例。单因素和多因素回归分析表明，PaO/FiO、SOFA 和 D-二聚体与 28 天死亡率独立相关。PaO/FiO、SOFA 评分和 D-二聚体联合预测死亡率的表现（受试者工作特征曲线下面积为 0.926）优于各单因素（分别为 0.761、0.745 和 0.878）。
结论
PaO/FiO、SOFA 评分和 D-二聚体联合可作为预测老年脓毒症患者 28 天死亡率的有前途的工具和生物标志物。
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