Gao Yan, Chen Yao, Gao Li
Intensive Care Unit, The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi, China.
Hemodialysis Unit, The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi, China.
Br J Hosp Med (Lond). 2024 Dec 30;85(12):1-12. doi: 10.12968/hmed.2024.0473. Epub 2024 Dec 27.
Sepsis is a life-threatening condition resulting from dysregulated immune responses to infection, leading to organ dysfunction. High-density lipoprotein (HDL) and red cell distribution width (RDW) have shown significant correlations with sepsis severity, yet the combined prognostic value of HDL and RDW in evaluating sepsis severity and outcomes remains unclear. This study examines the relationship between HDL and RDW levels and sepsis severity, as well as evaluates the combined utility of these markers in predicting disease severity and patient outcomes. This retrospective study included 103 patients diagnosed with sepsis. Clinical data, including HDL and RDW levels, were collected for analysis. Patients were divided into shock and non-shock groups based on the presence of septic shock and into survival and death groups based on 30-day in-hospital mortality. Multivariate logistic regression was used to identify factors influencing sepsis severity and prognosis, while the predictive value of HDL in combination with RDW was evaluated using receiver operating characteristic (ROC) curve analysis. Multivariate analysis identified sequential organ failure assessment (SOFA) score (OR = 6.566), interleukin-6 (IL-6) (OR = 2.568), HDL (OR = 0.864), and RDW (OR = 4.052) as independent predictors of sepsis severity ( < 0.05 for all). ROC analysis demonstrated that HDL combined with RDW yielded the highest diagnostic accuracy for sepsis severity, with an area under curve (AUC) of 0.962, sensitivity of 97.56%, and specificity of 91.94%. Additionally, SOFA score (OR = 2.354), interleukin-6 (IL-6) (OR = 1.446), HDL (OR = 0.870), and RDW (OR = 3.502) were independent prognostic indicators ( < 0.05 for all). ROC analysis for prognosis showed that HDL combined with RDW had the highest predictive efficacy for the prognosis of sepsis, with an AUC of 0.922, sensitivity of 79.31%, and specificity of 93.24%. The combination of HDL and RDW is a robust indicator for the evaluation of sepsis severity and is a valuable prognostic tool for assessing 30-day mortality risk in sepsis patients.
脓毒症是一种因对感染的免疫反应失调而导致的危及生命的病症，可引发器官功能障碍。高密度脂蛋白（HDL）和红细胞分布宽度（RDW）已显示出与脓毒症严重程度存在显著相关性，但HDL和RDW在评估脓毒症严重程度及预后方面的联合预后价值仍不明确。本研究探讨了HDL和RDW水平与脓毒症严重程度之间的关系，并评估了这些标志物在预测疾病严重程度和患者预后方面的联合效用。这项回顾性研究纳入了103例诊断为脓毒症的患者。收集包括HDL和RDW水平在内的临床数据进行分析。根据是否存在脓毒性休克将患者分为休克组和非休克组，并根据30天院内死亡率分为生存组和死亡组。采用多因素逻辑回归分析确定影响脓毒症严重程度和预后的因素，同时使用受试者工作特征（ROC）曲线分析评估HDL与RDW联合的预测价值。多因素分析确定序贯器官衰竭评估（SOFA）评分（OR = 6.566）、白细胞介素-6（IL-6）（OR = 2.568）、HDL（OR = 0.864）和RDW（OR = 4.052）为脓毒症严重程度的独立预测因素（均P < 0.05）。ROC分析表明，HDL与RDW联合对脓毒症严重程度的诊断准确性最高，曲线下面积（AUC）为0.962，敏感性为97.56%，特异性为91.94%。此外，SOFA评分（OR = 2.354）、白细胞介素-6（IL-6）（OR = 1.446）、HDL（OR = 0.870）和RDW（OR = 3.502）是独立的预后指标（均P < 0.05）。预后的ROC分析显示，HDL与RDW联合对脓毒症预后的预测效能最高，AUC为0.922，敏感性为79.31%，特异性为93.24%。HDL与RDW的联合是评估脓毒症严重程度的有力指标，也是评估脓毒症患者30天死亡风险的有价值的预后工具。
