Zhao Jingjing, Zhang Ye, Wang Junyu, Wei Bing, Liu Yugeng
Department of Infectious Disease and Clinical Microbiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, People's Republic of China.
Emergency Medicine Clinical Research Center, Beijing Chaoyang Hospital & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Clinical Center for Medicine in Acute Infection, Capital Medical University, Beijing, 100043, People's Republic of China.
J Inflamm Res. 2023 Oct 11;16:4481-4488. doi: 10.2147/JIR.S429080. eCollection 2023.
To investigate the potential role and prognostic value of interleukin-15 (IL-15) in predicting 28-day mortality in elderly patients with sepsis.
According to the Sepsis-3.0 diagnostic criteria for sepsis, elderly patients with sepsis who were admitted to the emergency department of the Shi jingshan branch of Beijing Chaoyang Hospital between October 2021 and June 2022 were enrolled in this retrospective cohort study. After observation for 28 days, patients were divided into a survival group and a nonsurvival group. Samples for laboratory tests, baseline characteristic data, and SOFA and Acute Physiology and Chronic Health Evaluation (APACHE II) scores were collected or recorded within 24 h after admission to the emergency department. Quantitative detection of IL-15 was performed with a Luminex assay. Logistic regression analysis and receiver operating characteristic curve (ROC) analysis were conducted for comparison.
In total, 220 elderly patients with sepsis were enrolled, 69 of whom were in the survival group and 151 of whom were in the nonsurvival group at the 28-day interval. Systolic pressure, high-density lipoprotein (HDL), platelets (PLT) and albumin (ALB) were significantly higher in the survival group (P<0.05), while IL-15, SOFA, and APACHE II were significantly higher in the nonsurvival group (P<0.05). IL-15 was an independent risk factor associated with 28-day mortality (OR=1.842, 95% CI [1.323, 2.565]). The area under the receiver operating characteristic curve (AUROC) of IL-15 alone was 0.691 (95% CI [0.618, 0.764]), with a sensitivity of 46.67% and a specificity of 85.81%. The AUROC of the combined IL-15 and SOFA reached 0.880 (95% CI [0.672, 0.812]), for which the sensitivity and specificity were 80.95% and 85.08%, respectively.
IL-15 possesses the prognostic value for predicting 28-day mortality in elderly patients with sepsis.
探讨白细胞介素-15(IL-15)在预测老年脓毒症患者28天死亡率中的潜在作用及预后价值。
根据脓毒症3.0诊断标准,选取2021年10月至2022年6月在北京朝阳医院石景山分院急诊科收治的老年脓毒症患者进行此项回顾性队列研究。观察28天后,将患者分为存活组和非存活组。在患者进入急诊科后24小时内收集或记录实验室检查样本、基线特征数据以及序贯器官衰竭评估(SOFA)和急性生理与慢性健康状况评分系统(APACHE II)评分。采用Luminex检测法对IL-15进行定量检测。进行逻辑回归分析和受试者工作特征曲线(ROC)分析以作比较。
共纳入220例老年脓毒症患者,在28天观察期时,存活组69例,非存活组151例。存活组的收缩压、高密度脂蛋白(HDL)、血小板(PLT)和白蛋白(ALB)显著更高(P<0.05),而非存活组的IL-15、SOFA和APACHE II显著更高(P<0.05)。IL-15是与28天死亡率相关的独立危险因素(OR=1.842,95%置信区间[1.323,2.565])。单独IL-15的受试者工作特征曲线下面积(AUROC)为0.691(95%置信区间[0.618,0.764]),灵敏度为46.67%,特异度为85.81%。IL-15与SOFA联合的AUROC达到0.880(95%置信区间[0.672,0.812]),其灵敏度和特异度分别为80.95%和85.08%。
IL-15对预测老年脓毒症患者28天死亡率具有预后价值。