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Received:May 18, 2023 Published Online:October 20, 2023
Received:May 18, 2023 Published Online:October 20, 2023
中文摘要: 目的 探讨序贯器官衰竭评分 (SOFA)联合降钙素原(PCT)对老年脓毒症相关急性肾损伤(AKI)患者住院期间死亡的预测价值。
方法 回顾性纳入2018年1月至2022年12月哈尔滨医科大学附属第一医院住院治疗的176例脓毒症相关AKI患者,根据住院期间转归,分为死亡组62例(35.23%),存活组114例(64.77%)。分析脓毒症相关AKI患者住院期间死亡的独立危险因素及SOFA评分、PCT对患者死亡的预测效能。
结果 单因素分析显示,与存活组比较,死亡组年龄>70岁、合并糖尿病、肾脏替代治疗的比例以及凝血酶原时间、PCT、乳酸、急性生理学及慢性健康状况Ⅱ(APACHE Ⅱ)评分、SOFA评分均升高(P<0.05)。多因素logistic回归分析显示,年龄>70岁(OR=1.241)、PCT>3.40 ng/mL(OR=1.398)、APACHE Ⅱ>25分(OR=1.706)、SOFA>8.5分(OR=1.779)是脓毒症相关AKI患者住院期间死亡的独立危险因素(P<0.05)。ROC曲线显示,SOFA评分联合PCT预测脓毒症相关AKI患者住院期间死亡的AUC最高[0.855(95%CI: 0.806~0.904)]。
结论 SOFA评分及PCT与脓毒症相关AKI患者的预后具有相关性,二者联合可预测其住院期间全因死亡风险,从而辅助临床快速筛查高风险个体并进行干预。
Abstract:ObjectiveTo explore the predictive value of sequential organ failure assessment (SOFA) score combined with procalcitonin (PCT) in the death of sepsis-related acute kidney injury (AKI) elderly patients during hospitalization.
Methods A total of 176 patients with sepsis-related AKI hospitalized in the First Affiliated Hospital of Harbin Medical University from January 2018 to December 2022 were retrospectively included. According to the outcome during hospitalization, they were divided into the death group of 62 patients (35.23%) and the survival group of 114 patients (64.77%). The independent risk factors for death during hospitalization and the predicting efficacy of SOFA score and PCT in the death of sepsis-related AKI patients were analyzed.
Results Univariate analysis showed that the proportion of age >70 years, diabetes, renal replacement therapy, and the levels of prothrombin time, PCT, lactate, APACHE Ⅱ, and SOFA score were all higher in the death group compared to the survival group (P<0.05). The multivariate logistic regression analysis showed that age>70 years old (OR=1.241), PCT>3.40 ng/mL (OR=1.398), APACHE Ⅱ>25 points (OR=1.706), and SOFA>8.5 points (OR=1.779) were the independent risk factors for mortality during hospitalization in sepsis-related AKI patients. ROC showed that SOFA score combined with PCT had the highest AUC in predicting the death of sepsis-related AKI patients during hospitalization [0.855 (95%CI: 0.806-0.904)]. Conclusion SOFA score and PCT are correlated with the prognosis of sepsis-related AKI patients, and their combination can predict the risk of all-cause mortality during hospitalization, thus aiding rapid clinical screening and intervention for high-risk individuals.
文章编号: 中图分类号:R459.7 文献标志码:A
基金项目:黑龙江省自然科学基金(H2019035)
Author Name | Affiliation |
XU Caihong, WANG Guannan | Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, China |
Author Name | Affiliation |
XU Caihong, WANG Guannan | Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150000, China |
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