Liu Min, Duan Yun-Jiao, Zhang Ye, Yang Jun, Wei Bing, Wang Junyu
Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, & Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Clinical Center for Medicine in Acute Infection, Capital Medical University, Beijing, People's Republic of China.
J Inflamm Res. 2024 Mar 8;17:1503-1509. doi: 10.2147/JIR.S447142. eCollection 2024.
This study examines the effectiveness of MIP-3alpha and severity scores in determining the prognosis of elderly sepsis patients.
From October 2020 to April 2021, a total of 171 elderly sepsis patients were admitted to the Emergency Department of the Shijingshan Branch of Beijing Chaoyang Hospital, Capital Medical University. According to the 28-day mortality rate, they were divided into two groups: survivors (48 cases) and deaths (123 cases). At admission, severity scores which are the Sequential Organ Failure Assessment (SOFA) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) were calculated. The logistic regression was used to analyze the independent risk factors associated with 28-day mortality in elderly sepsis patients. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the value of MIP-3alpha, SOFA, and APACHE II in the evaluation of 28-day mortality in elderly sepsis patients.
MIP-3alpha, SOFA and APACHE II of the death group were significantly higher than those of the survival group (P < 0.05). Multivariate logistic regression analysis showed that MIP-3alpha, SOFA, APACHE II, and systolic blood pressure (SBP) were independent risk factors for 28-day mortality of senile sepsis (P < 0.05). Analysis of the ROC curve revealed that MIP-3alpha, SOFA, APACHE II had predictive value for the 28-day prognosis of senile sepsis (all P < 0.01). Combing with MIP-3alpha and SOFA showed better predictive ability (Z1 = 3.733, Z2 = 2.996, both P < 0.01), compared to detecting MIP-3alpha and SOFA alone.
In senile sepsis, MIP-3alpha, SOFA, APACHE II and SBP are independent risk factors for 28-day mortality. The combination of MIP-3alpha and SOFA can further enhance the predictive value of 28-day mortality in patients with senile sepsis and provide some reference value for the evaluation and treatment of senile sepsis.
本研究旨在探讨巨噬细胞炎性蛋白-3α（MIP-3α）及严重程度评分在老年脓毒症患者预后判断中的有效性。
2020年10月至2021年4月，首都医科大学附属北京朝阳医院石景山院区急诊科共收治171例老年脓毒症患者。根据28天死亡率将其分为两组：存活组（48例）和死亡组（123例）。入院时计算序贯器官衰竭评估（SOFA）和急性生理与慢性健康状况评分系统II（APACHE II）这两个严重程度评分。采用逻辑回归分析老年脓毒症患者28天死亡率的独立危险因素。采用受试者工作特征（ROC）曲线及曲线下面积（AUC）评估MIP-3α、SOFA及APACHE II在评估老年脓毒症患者28天死亡率中的价值。
死亡组的MIP-3α、SOFA及APACHE II显著高于存活组（P<0.05）。多因素逻辑回归分析显示，MIP-3α、SOFA、APACHE II及收缩压（SBP）是老年脓毒症28天死亡率的独立危险因素（P<0.05）。ROC曲线分析显示，MIP-3α、SOFA、APACHE II对老年脓毒症28天预后具有预测价值（均P<0.01）。与单独检测MIP-3α和SOFA相比，联合MIP-3α和SOFA显示出更好的预测能力（Z1 = 3.733，Z2 = 2.996，均P<0.01）。
在老年脓毒症中，MIP-3α、SOFA、APACHE II及SBP是28天死亡率的独立危险因素。MIP-3α与SOFA联合可进一步提高老年脓毒症患者28天死亡率的预测价值，为老年脓毒症的评估和治疗提供一定参考价值。
