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改良HALP评分与脓毒症重症患者的短期死亡率相关——一项队列研究。

The modified HALP score is associated with short-term mortality in critically ill patients with sepsis - A cohort study.

作者信息

Lin Lanzhi, Huang Huifang, Wu Meiying, Chen Fang, Li Chaojing

机构信息

Intensive Care Unit, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350001, China.

出版信息

J Infect Dev Ctries. 2025 Jun 30;19(6):924-933. doi: 10.3855/jidc.20755.

Abstract

INTRODUCTION

To systematically appraise the prognostic predictive value of the modified HALP (m-HALP) score in critically ill septic patients.

METHODOLOGY

The m-HALP scores were computed for septic patients within the initial 24 hours of admission to the intensive care unit (ICU) utilizing data from the MIMIC-IV database. The association between the m-HALP score and 30-day mortality was evaluated using restricted cubic splines and Cox regression. Kaplan-Meier (K-M) analysis was employed to estimate survival differences. Logistic regression was conducted using data from the eICU database to validate the findings. Receiver operator characteristic (ROC) curves were generated to assess predictive value.

RESULTS

The m-HALP score exhibited an L-shaped association with 30-day mortality upon adjustment for multiple variables (HR: 0.84, 95% CI: 0.74-0.96). K-M curves revealed a favorable survival outcome in patients with high m-HALP scores (p < 0.001). In the validation cohort, the m-HALP score proved to be an independent factor influencing in-hospital mortality. The ROC curves suggested that the m-HALP score had a better predictive value for short-term sepsis mortality than the HALP and qSOFA score.

CONCLUSIONS

The m-HALP score demonstrated a noteworthy correlation with short-term mortality of septic patients, making it a potentially promising biomarker of prognostic relevance.

摘要

引言

系统评估改良HALP(m-HALP)评分对重症脓毒症患者的预后预测价值。

方法

利用MIMIC-IV数据库的数据,计算重症监护病房(ICU)收治的脓毒症患者入院后最初24小时内的m-HALP评分。采用受限立方样条和Cox回归评估m-HALP评分与30天死亡率之间的关联。采用Kaplan-Meier(K-M)分析估计生存差异。使用eICU数据库的数据进行逻辑回归以验证研究结果。生成受试者工作特征(ROC)曲线以评估预测价值。

结果

在对多个变量进行调整后,m-HALP评分与30天死亡率呈L形关联(HR:0.84,95%CI:0.74-0.96)。K-M曲线显示,m-HALP评分高的患者生存结局良好(p<0.001)。在验证队列中,m-HALP评分被证明是影响住院死亡率的独立因素。ROC曲线表明,m-HALP评分对短期脓毒症死亡率的预测价值优于HALP和qSOFA评分。

结论

m-HALP评分与脓毒症患者的短期死亡率显著相关,使其成为具有潜在预后相关性的生物标志物。

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