全身免疫炎症指数联合快速序贯器官衰竭评估评分对脓毒症患者死亡率的预测价值

Systemic immune-inflammation index combined with quick sequential organ failure assessment score for predicting mortality in sepsis patients.

作者信息

Liu Changya, Wu Xinxin, Deng Rou, Xu Xiangru, Chen Caiyu, Wu Linguangjin, Zhang Wen, Yang Hongqiang, Fei Yuerong, Sun Yuting, Zhou Shuang, Fang Bangjiang

机构信息

Department of Emergency, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.

Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 200443, Shanghai, China.

出版信息

Heliyon. 2023 Aug 30;9(9):e19526. doi: 10.1016/j.heliyon.2023.e19526. eCollection 2023 Sep.

OBJECTIVE

To evaluate the prognostic ability of systemic immune-inflammation index (SII) combine with quick Sequential Organ Failure Assessment (qSOFA) criteria in predicting the 28-day mortality of sepsis.

METHODS

A retrospective cohort study was conducted, with the population comprised in whom sepsis was confirmed. Clinical and laboratory data recorded were analyzed. The score of Sequential Organ Failure Assessment (SOFA), SII, qSOFA were calculated. Multivariable regression, receiver operating characteristic (ROC) analysis and Kaplan-Meier method were used to identify and compared the predictors of prognosis among SOFA, qSOFA, and the combination of SII with qSOFA.

RESULTS

A total of 349 patients admitted from December 2020 and December 2022 were included in the cohort. 95 (27.2%) of whom had died by day 28. The SII, SOFA, and qSOFA scores were significant higher in the non-survivors than that of survivors (P < 0.05), and identified as independent predictors of sepsis mortality. The addition of SII to qSOFA shown an area under receiver operator characteristic (AUROC) of 0.840 (95% CI: 0.787-0.884), manifested an effective ability in predicting poor outcome than other scoring systems. The optimum cutoff for SII (>1.7668) and qSOFA (>1) represented a high risk level in 28-day mortality of sepsis, were performed and identified in Kaplan-Meier survival curves (log-rank test, HR: 6.942, 95% CI: 3.976-12.121; P < 0.0001).

CONCLUSION

The SII in addition to qSOFA provided an effective prognostic tool for predicting mortality in sepsis.

目的

评估全身免疫炎症指数（SII）联合快速序贯器官衰竭评估（qSOFA）标准预测脓毒症28天死亡率的预后能力。

方法

进行一项回顾性队列研究，纳入确诊为脓毒症的人群。对记录的临床和实验室数据进行分析。计算序贯器官衰竭评估（SOFA）、SII、qSOFA评分。采用多变量回归、受试者工作特征（ROC）分析和Kaplan-Meier方法来识别和比较SOFA、qSOFA以及SII与qSOFA联合使用时的预后预测因素。

结果

该队列共纳入2020年12月至2022年12月收治的349例患者。其中95例（27.2%）在第28天死亡。非幸存者的SII、SOFA和qSOFA评分显著高于幸存者（P<0.05），并被确定为脓毒症死亡率的独立预测因素。将SII加入qSOFA后，受试者工作特征曲线下面积（AUROC）为0.840（95%CI：0.787 - 0.884），表明其预测不良结局的能力优于其他评分系统。SII（>1.7668）和qSOFA（>1）的最佳截断值在Kaplan-Meier生存曲线中显示出脓毒症28天死亡率的高风险水平（对数秩检验，HR：6.942，95%CI：3.976 - 12.121；P<0.0001）。