Department of Emergency, Renji Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai, China.
PLoS One. 2024 Apr 11;19(4):e0302063. doi: 10.1371/journal.pone.0302063. eCollection 2024.
This prospective observational study explored the predictive value of CD86 in the early diagnosis of sepsis in the emergency department. The primary endpoint was the factors associated with a diagnosis of sepsis. The secondary endpoint was the factors associated with mortality among patients with sepsis. It enrolled inpatients with infection or high clinical suspicion of infection in the emergency department of a tertiary Hospital between September 2019 and June 2021. The patients were divided into the sepsis and non-sepsis groups according to the Sepsis-3 standard. The non-sepsis group included 56 patients, and the sepsis group included 65 patients (19 of whom ultimately died). The multivariable analysis showed that CD86% (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.04-1.44, P = 0.015), platelet count (OR = 0.99, 95%CI: 0.986-0.997, P = 0.001), interleukin-10 (OR = 1.01, 95%CI: 1.004-1.025, P = 0.009), and procalcitonin (OR = 1.17, 95%CI: 1.01-1.37, P = 0.043) were independent risk factors for sepsis, while human leukocyte antigen (HLA%) (OR = 0.96, 05%CI: 0.935-0.995, P = 0.022), respiratory rate (OR = 1.16, 95%CI: 1.03-1.30, P = 0.014), and platelet count (OR = 1.01, 95%CI: 1.002-1.016, P = 0.016) were independent risk factors for death in patients with sepsis. The model for sepsis (CD86%, platelets, interleukin-10, and procalcitonin) and the model for death (HLA%, respiratory rate, and platelets) had an area under the curve (AUC) of 0.870 and 0.843, respectively. CD86% in the first 24 h after admission for acute infection was independently associated with the occurrence of sepsis in the emergency department.
这项前瞻性观察研究探讨了 CD86 在急诊科脓毒症早期诊断中的预测价值。主要终点是与脓毒症诊断相关的因素。次要终点是与脓毒症患者死亡率相关的因素。它纳入了 2019 年 9 月至 2021 年 6 月期间在一家三级医院急诊科感染或高度疑似感染的住院患者。根据 Sepsis-3 标准,患者分为脓毒症组和非脓毒症组。非脓毒症组包括 56 例患者,脓毒症组包括 65 例患者(其中 19 例最终死亡)。多变量分析显示,CD86%(比值比[OR] = 1.22,95%置信区间[CI]:1.04-1.44,P = 0.015)、血小板计数(OR = 0.99,95%CI:0.986-0.997,P = 0.001)、白细胞介素-10(OR = 1.01,95%CI:1.004-1.025,P = 0.009)和降钙素原(OR = 1.17,95%CI:1.01-1.37,P = 0.043)是脓毒症的独立危险因素,而人类白细胞抗原(HLA%)(OR = 0.96,05%CI:0.935-0.995,P = 0.022)、呼吸频率(OR = 1.16,95%CI:1.03-1.30,P = 0.014)和血小板计数(OR = 1.01,95%CI:1.002-1.016,P = 0.016)是脓毒症患者死亡的独立危险因素。脓毒症模型(CD86%、血小板、白细胞介素-10 和降钙素原)和死亡模型(HLA%、呼吸频率和血小板)的曲线下面积(AUC)分别为 0.870 和 0.843。急性感染入院后 24 小时内的 CD86%与急诊科脓毒症的发生独立相关。