Department of Emergency, Xijing Hospital, Fourth Military Medical University, Xian, Shaanxi, China.
Department of Respiratory and Clinical Care Medicine, Shanghai Sixth People's Hospital, Shanghai, China.
PeerJ. 2023 Sep 5;11:e15910. doi: 10.7717/peerj.15910. eCollection 2023.
To investigate the indicators affecting the early outcome of patients with sepsis and to explore its prognostic efficacy for sepsis.
We collected clinical data from 201 patients with sepsis admitted to the emergency department of Xijing Hospital between June 2019 and June 2022. The patients were categorized into groups (survival or fatality) based on their 28-day prognosis. The clinical characteristics, biochemical indexes, organ function-related indicators, and disease scores of the patients were analyzed for both groups. Risk factor analysis was conducted for the indicators with significant differences.
Among the indicators with significant differences between the deceased and survival groups, D-dimer (D-DI), Sequential Organ Failure Assessment (SOFA) score, platelet (PLT), international normalized ratio (INR), and D-DI/PLT were identified as independent risk factors affecting the prognosis of sepsis patients. Receiver operating characteristic (ROC) curves showed that D-DI/PLT (area under the curve (AUC) = 93.9), D-DI (AUC = 89.6), PLT (AUC = 81.3), and SOFA (AUC = 78.4) had good judgment efficacy. Further, Kaplan Meier (K-M) survival analysis indicated that the 28-day survival rates of sepsis patients were significantly decreased when they had high levels of D-DI/PLT, D-DI, and SOFA as well as low PLTs. The hazard ratio (HR) of D-DI/PLT between the two groups was the largest (HR = 16.19).
D-DI/PLT may be an independent risk factor for poor prognosis in sepsis as well as a clinical predictor of patient prognosis.
探讨影响脓毒症患者早期预后的相关指标,探索其对脓毒症的预后评估效能。
收集 2019 年 6 月至 2022 年 6 月西京医院急诊收治的脓毒症患者 201 例的临床资料,根据患者 28 天预后分为存活组和死亡组。对两组患者的临床特征、生化指标、器官功能相关指标、疾病评分等进行分析,对差异有统计学意义的指标进行危险因素分析。
死亡组与存活组间差异有统计学意义的指标中,D-二聚体(D-Dimer,D-DI)、序贯器官衰竭评估(Sequential Organ Failure Assessment,SOFA)评分、血小板(Platelet,PLT)、国际标准化比值(International Normalized Ratio,INR)、D-DI/PLT 是影响脓毒症患者预后的独立危险因素。受试者工作特征(Receiver Operating Characteristic,ROC)曲线显示,D-DI/PLT(曲线下面积(Area Under the Curve,AUC)=93.9)、D-DI(AUC=89.6)、PLT(AUC=81.3)、SOFA(AUC=78.4)判断效能较好。进一步的 Kaplan-Meier(K-M)生存分析表明,D-DI/PLT、D-DI、SOFA 水平升高和 PLT 降低的脓毒症患者 28 天生存率明显降低,且 D-DI/PLT 组间的风险比(Hazard Ratio,HR)最大(HR=16.19)。
D-DI/PLT 可能是脓毒症不良预后的独立危险因素,也是患者预后的临床预测指标。