Department of Emergency Medicine, Intensive Care Unit, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland).
Med Sci Monit. 2023 Jan 25;29:e938538. doi: 10.12659/MSM.938538.
BACKGROUND This study aimed to evaluate the possible associations of heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein (CRP) levels with 28-day mortality in septic shock patients admitted to Intensive Care Units (ICUs). MATERIAL AND METHODS Blood samples were taken at ICU admission and measured again 72 h later to calculate changes in HBP (ΔHBP), changes in PCT (ΔPCT), changes in CRP (ΔCRP), and changes in Sequential Organ Failure Assessment (DSOFA) relative to baseline. RESULTS Variables included in the univariable logistic regression model for survival were age, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, decreasing ΔSOFA, decreasing DHBP, decreasing ΔPCT, and decreasing ΔCRP. Survival was directly related to decreasing ΔHBP with odds ratio (OR)=9.95 (95% confidence interval [CI] 4.63 to 21.35; P<0.001), decreasing ΔPCT with OR=7.85 (3.74 to 16.49; P<0.001), decreasing ΔCRP with OR=5.83 (2.84 to 11.97; P<0.001), decreasing ΔSOFA with OR=1.93 (1.00 to 3.75; P=0.051) and APACHE II score with OR=1.93 (1.14 to 1.68; P=0.001). In a multivariable logistic regression model for survival, only decreasing DHBP with OR=7.18 (2.91 to 17.69; P<0.001), decreasing ΔPCT with OR=5.17 (2.12 to 12.56; P<0.001), and decreasing ΔCRP with OR=4.33 (1.77 to 10.61; P=0.001) remained significant. CONCLUSIONS Measuring changes in HBP, PCT, and CRP within 72 h of admission may aid in predicting 28-day mortality for patients with septic shock in ICUs.
本研究旨在评估肝素结合蛋白(HBP)、降钙素原(PCT)和 C 反应蛋白(CRP)水平与入住重症监护病房(ICU)的脓毒症休克患者 28 天死亡率之间的可能相关性。
在 ICU 入院时采集血样,并在 72 小时后再次测量,以计算相对于基线的 HBP(ΔHBP)、PCT(ΔPCT)、CRP(ΔCRP)和序贯器官衰竭评估(SOFA)的变化。
单变量逻辑回归模型中用于生存的变量包括年龄、急性生理学和慢性健康评估(APACHE)II 评分、SOFA 下降、DHBP 下降、PCT 下降和 CRP 下降。生存与 DHBP 下降直接相关,优势比(OR)=9.95(95%置信区间[CI] 4.63 至 21.35;P<0.001),PCT 下降与 OR=7.85(3.74 至 16.49;P<0.001),CRP 下降与 OR=5.83(2.84 至 11.97;P<0.001),SOFA 下降与 OR=1.93(1.00 至 3.75;P=0.051)和 APACHE II 评分与 OR=1.93(1.14 至 1.68;P=0.001)。在生存的多变量逻辑回归模型中,只有 DHBP 下降与 OR=7.18(2.91 至 17.69;P<0.001)、PCT 下降与 OR=5.17(2.12 至 12.56;P<0.001)和 CRP 下降与 OR=4.33(1.77 至 10.61;P=0.001)仍然显著。
在入住 ICU 的脓毒症休克患者中,在 72 小时内测量 HBP、PCT 和 CRP 的变化可能有助于预测 28 天死亡率。