Department of Intensive Care Unit, Qinhuangdao Jungong Hospital, Qinhuangdao, Hebei, P. R. China.
Department of Operating Room, Qinhuangdao Jungong Hospital, Qinhuangdao, Hebei, P. R. China.
PLoS One. 2022 Sep 6;17(9):e0273377. doi: 10.1371/journal.pone.0273377. eCollection 2022.
To date, sepsis remains the main cause of mortality in intensive care units (ICU). This study aimed analyze the risk factors of the prognosis in sepsis patients.
In this case-control study, patients with sepsis admitted to the intensive care unit of a Chinese hospital between January and November 2020 were analyzed. Ultrasound and clinical data were analyzed and compared between non-survivors and survivors. The ROC curve analysis was also performed to determine the best indicator for predicting mortality.
A total of 72 patients with sepsis in ICU were included for analysis. The basic characteristics between the survivals and non-survivals were similar, except for acute physiology and chronic health evaluation (APACHE) Ⅱ score, sepsis-related organ failure assessment (SOFA) score, lactate level, ultrasound parameters from superior mesenteric artery (SMA) such as peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI). Univariate analysis revealed that the APACHE Ⅱ score, SOFA score, lactate, low PSV, EDV, and RI were potential risk factors for mortality in sepsis, while multivariate analysis suggested that low PSV was an independent risk factor for mortality, and the adjusted odds ratio was 0.295 (95% CI: 0.094-0.925). The ROC analysis showed that the PSV (AUC = 0.99; sensitivity and specificity were 0.99 and 0.96, respectively) had good predictive value for mortality in sepsis.
Low PSV as found to be an independent risk factor and good predictor for mortality in patients with sepsis. This study shows the promise of ultrasound in predicting mortality in patients with sepsis; however, further studies are needed to validate these results.
迄今为止，脓毒症仍然是重症监护病房（ICU）患者死亡的主要原因。本研究旨在分析脓毒症患者预后的危险因素。
在这项病例对照研究中，分析了 2020 年 1 月至 11 月期间在中国医院 ICU 住院的脓毒症患者。对超声和临床数据进行了分析，并比较了存活者和非存活者之间的数据。还进行了 ROC 曲线分析，以确定预测死亡率的最佳指标。
共纳入 72 例 ICU 脓毒症患者进行分析。存活者和非存活者的基本特征相似，但急性生理学和慢性健康评估（APACHE）Ⅱ评分、脓毒症相关器官衰竭评估（SOFA）评分、乳酸水平、肠系膜上动脉（SMA）的超声参数如收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）除外。单因素分析显示，APACHE Ⅱ评分、SOFA 评分、乳酸、低 PSV、EDV 和 RI 是脓毒症患者死亡的潜在危险因素，而多因素分析表明低 PSV 是死亡的独立危险因素，调整后的比值比为 0.295（95%CI：0.094-0.925）。ROC 分析显示 PSV（AUC=0.99；灵敏度和特异性分别为 0.99 和 0.96）对脓毒症患者死亡率具有良好的预测价值。
低 PSV 是脓毒症患者死亡的独立危险因素和良好预测指标。本研究表明超声在预测脓毒症患者死亡率方面具有潜力；然而，还需要进一步的研究来验证这些结果。
