He Yujing, Zheng Caixia, Zeng Jianyong, Fu Yaojie, Ou Hongjie
Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361000, P.R. China.
Department of Infectious Diseases, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361000, P.R. China.
Exp Ther Med. 2024 Dec 31;29(2):42. doi: 10.3892/etm.2024.12792. eCollection 2025 Feb.
Sepsis, a condition characterized by a dysregulated host response to infection, can progress to septic shock and lead to various complications. The present study aimed to identify risk factors for the early clinical identification of sepsis patients at heightened risk of complications. In the present study, a total of 383 hospitalized patients with sepsis and positive blood cultures were enrolled. Demographic characteristics, laboratory findings at admission and treatment outcomes were collected and analyzed. Among the 383 sepsis patients, 165 were diagnosed with acute kidney injury (AKI). Patients with AKI exhibited significantly lower platelet counts, elevated procalcitonin levels and higher Sequential Organ Failure Assessment (SOFA) scores. Logistic regression analysis identified the SOFA score [odds ratio (OR)=1.269, 95% confidence interval (CI): 1.067-1.510, P=0.007) as an independent predictor of AKI. Furthermore, patients with septic shock had lower platelet counts and higher white blood cell counts at admission. Multivariable analysis revealed that age (OR=1.024, 95% CI: 1.001-1.047, P=0.039), procalcitonin (OR=1.018, 95% CI: 1.003-1.032, P=0.015), SOFA score (OR=1.465, 95% CI: 1.248-1.719, P<0.001) and Pitt bacteremia score (OR=1.437, 95% CI: 1.204-1.716, P<0.001) were independently associated with septic shock. In addition, sepsis patients with acute respiratory distress syndrome (ARDS) were observed to have lower platelet counts, higher body weight and elevated alanine aminotransferase levels. Multivariable analysis identified the SOFA score (OR=1.177, 95% CI: 1.095-1.265, P<0.001) and body weight (OR=1.030, 95% CI: 1.007-1.054, P=0.010) as independent predictors of ARDS. The present study highlights the risk factors associated with AKI, ARDS and septic shock in sepsis patients with positive blood cultures. Early identification and close monitoring of these factors are crucial for improving outcomes in sepsis management.
脓毒症是一种以宿主对感染的反应失调为特征的病症，可进展为感染性休克并导致各种并发症。本研究旨在确定在并发症风险较高的脓毒症患者早期临床识别中的危险因素。在本研究中，共纳入了383例住院的血培养阳性的脓毒症患者。收集并分析了人口统计学特征、入院时的实验室检查结果和治疗结果。在383例脓毒症患者中，165例被诊断为急性肾损伤（AKI）。AKI患者的血小板计数显著降低，降钙素原水平升高，序贯器官衰竭评估（SOFA）评分更高。逻辑回归分析确定SOFA评分[比值比（OR）=1.269，95%置信区间（CI）：1.067 - 1.510，P = 0.007]是AKI的独立预测因素。此外，感染性休克患者入院时的血小板计数较低，白细胞计数较高。多变量分析显示，年龄（OR = 1.024，95% CI：1.001 - 1.047，P = 0.039）、降钙素原（OR = 1.018，95% CI：1.003 - 1.032，P = 0.015）、SOFA评分（OR = 1.465，95% CI：1.248 - 1.719，P < 0.001）和皮特菌血症评分（OR = 1.437，95% CI：1.204 - 1.716，P < 0.001）与感染性休克独立相关。此外，观察到患有急性呼吸窘迫综合征（ARDS）的脓毒症患者血小板计数较低、体重较高且丙氨酸转氨酶水平升高。多变量分析确定SOFA评分（OR = 1.177，95% CI：1.095 - 1.265，P < 0.001）和体重（OR = 1.030，95% CI：1.007 - 1.054，P = 0.010）是ARDS的独立预测因素。本研究强调了血培养阳性的脓毒症患者中与AKI、ARDS和感染性休克相关的危险因素。早期识别和密切监测这些因素对于改善脓毒症管理的结果至关重要。
