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序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康状况评分系统(APACHE)II评分及白细胞计数在脓毒症患者死亡风险评估中的价值:一项回顾性研究

Value of SOFA score, APACHE II score, and WBC count for mortality risk assessment in septic patients: A retrospective study.

作者信息

Li Dengkai, Wei Yanfang, Zhang Chunfang, Yang Yun, Wang Zhenqiang, Lu Yaru, Liu Lei

机构信息

Department of Intensive Care Unit, Aviation General Hospital, Beijing, China.

Department of Intensive Care Unit, Beijing Red Cross Emergency Rescue Center, Beijing, China.

出版信息

Medicine (Baltimore). 2025 May 16;104(20):e42464. doi: 10.1097/MD.0000000000042464.

Abstract

Sepsis is characterized by rapid onset, swift progression, and poor prognosis. Delay in early recognition and treatment may easily escalate to septic shock, resulting in a markedly high mortality rate. Early prognosis assessment holds significant value in enhancing the clinical outcomes of septic patients. The sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation II (APACHE II) score are commonly utilized clinical tools for assessing patients' conditions, while white blood cell (WBC) count is frequently employed to evaluate the inflammatory status of the body. The study aimed to investigate the prognostic value of SOFA score, APACHE II score, and WBC count in assessing the risk of mortality in septic patients, providing valuable insights for improving the prognosis of septic patients. In this retrospective study, 139 patients diagnosed with sepsis in our hospital from January 2021 to December 2023 were selected as the study subjects. Clinical outcomes of the patients were collected through a 28-day follow-up period, and patients were categorized into the survival group (n = 96) and the death group (n = 43). The value of SOFA score, APACHE II score, and WBC count for the mortality risk assessment in septic patients was calculated by plotting ROC curves, and the risk factors for mortality in septic patients were analyzed. The AUC of SOFA score was 0.809 (95% CI = 0.734-0.871, P < .0001) for predicting the mortality risk of sepsis. The AUC of APACHE score was 0.806 (95% CI = 0.729-0.884, P < .0001) for predicting the mortality risk of sepsis. The AUC of WBC count was 0.689 (95% CI = 0.591-0.788, P = .004) for predicting the mortality risk of sepsis. The AUC of combined detection was 0.861 (95% CI = 0.792-0.914, P < .0001) for predicting the mortality risk of sepsis. Univariate analysis revealed that SOFA, APACHE II, and WBC were correlated with mortality in septic patients (P < .05). Patients with sepsis demonstrate significant elevations in WBC count, SOFA, and APACHE II scores. The combined application of these indicators holds considerable value in predicting the mortality outcomes of septic patients. Accordingly, clinical treatment plans can be adjusted based on these aforementioned indicators to ameliorate the prognosis of septic patients.

摘要

脓毒症的特点是起病迅速、进展迅猛且预后不佳。早期识别和治疗的延迟可能很容易升级为感染性休克,导致死亡率显著升高。早期预后评估对于提高脓毒症患者的临床结局具有重要价值。序贯器官衰竭评估(SOFA)评分和急性生理与慢性健康状况评估II(APACHE II)评分是常用的评估患者病情的临床工具,而白细胞(WBC)计数经常用于评估机体的炎症状态。本研究旨在探讨SOFA评分、APACHE II评分和WBC计数在评估脓毒症患者死亡风险中的预后价值,为改善脓毒症患者的预后提供有价值的见解。在这项回顾性研究中,选取了2021年1月至2023年12月在我院诊断为脓毒症的139例患者作为研究对象。通过28天的随访期收集患者的临床结局,并将患者分为生存组(n = 96)和死亡组(n = 43)。通过绘制ROC曲线计算SOFA评分、APACHE II评分和WBC计数对脓毒症患者死亡风险评估的价值,并分析脓毒症患者死亡的危险因素。SOFA评分预测脓毒症死亡风险的AUC为0.809(95%CI = 0.734 - 0.871,P <.0001)。APACHE评分预测脓毒症死亡风险的AUC为0.806(95%CI = 0.729 - 0.884,P <.0001)。WBC计数预测脓毒症死亡风险的AUC为0.689(95%CI = 0.591 - 0.788,P =.004)。联合检测预测脓毒症死亡风险的AUC为0.861(95%CI = 0.792 - 0.914,P <.0001)。单因素分析显示,SOFA、APACHE II和WBC与脓毒症患者的死亡率相关(P <.05)。脓毒症患者的WBC计数、SOFA和APACHE II评分显著升高。这些指标的联合应用在预测脓毒症患者的死亡结局方面具有重要价值。因此,可以根据上述指标调整临床治疗方案,以改善脓毒症患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0df/12091671/9f336fa02533/medi-104-e42464-g001.jpg

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