SOFA评分、乳酸和血红蛋白对脓毒症预后预测价值
摘要
红蛋白浓度对脓毒症患者预后的预测价值。方法：回顾性分析2023年9月至2024年7月安徽医科大学第一附属医
院收治的128例脓毒症患者的临床资料，根据患者28天生存情况分为生存组（n=77）和死亡组（n=51）。通过绘制
受试者工作特征曲线（ROC曲线）比较SOFA评分、乳酸、血红蛋白单独及联合对脓毒症患者28天预后的预测价
值。结果：死亡组SOFA评分、乳酸水平显著高于生存组（P＜0.05），血红蛋白水平显著低于生存组（P＜0.05）。
多因素logistic回归分析显示，SOFA评分、乳酸更高、血红蛋白更低为脓毒症患者28天死亡的独立危险因素（P
＜0.05）。ROC曲线分析显示，SOFA评分联合乳酸及血红蛋白（AUC=0.791，95% CI：0.709-0.873）相比SOFA
评分（AUC=0.746，95% CI：0.660-0.832）、乳酸（AUC=0.729，95% CI：0.639-0.819）、血红蛋白（AUC=0.325，
95% CI：0.224-0.426）单独预测脓毒症患者28天死亡具有更高预测价值。结论：SOFA评分联合乳酸及血红蛋白浓
度对脓毒症患者28天预后具有较高的预测价值。
关键词
全文:
PDF参考
[1]SINGER M, DEUTSCHMAN C S, SEYMOUR C
W, et al. The Third International Consensus Definitions for
Sepsis and Septic Shock (Sepsis-3) [J]. JAMA, 2016, 315(8):
801-10.
[2]LIU Y-C, YAO Y, YU M-M, et al. Frequency and
mortality of sepsis and septic shock in China: a systematic
review and meta-analysis [J]. BMC Infect Dis, 2022, 22(1):
564.
[3]LIU Z, MENG Z, LI Y, et al. Prognostic accuracy of
the serum lactate level, the SOFA score and the qSOFA score
for mortality among adults with Sepsis [J]. Scand J Trauma
Resusc Emerg Med, 2019, 27(1): 51.
[4]SINGER A J, TAYLOR M, DOMINGO A, et
al. Diagnostic characteristics of a clinical screening tool
in combination with measuring bedside lactate level in
emergency department patients with suspected sepsis [J]. Acad
Emerg Med, 2014, 21(8): 853-7.
[5]ZHU J, DONG Y, LIAO P, et al. Prognostic value
of hemoglobin in patients with sepsis: A systematic review and
meta-analysis [J]. Heart Lung, 2024, 64: 93-9.
[6]BAUER M, GERLACH H, VOGELMANN T,
et al. Mortality in sepsis and septic shock in Europe, North
America and Australia between 2009 and 2019- results from a
systematic review and meta-analysis [J]. Critical care (London,
England), 2020, 24(1): 239.
[7]VINCENT J-L, SAKR Y. Clinical trial design for
unmet clinical needs: a spotlight on sepsis [J]. Expert Rev Clin
Pharmacol, 2019, 12(9): 893-900.
[8]MORENO R, RHODES A, PIQUILLOUD L, et
al. The Sequential Organ Failure Assessment (SOFA) Score:
has the time come for an update? [J]. Critical care (London,
England), 2023, 27(1): 15.
[9]VINCENT J-L, BAKKER J. Blood lactate levels in
sepsis: in 8 questions [J]. Curr Opin Crit Care, 2021, 27(3):
298-302.
[10]MALLAT J, RAHMAN N, HAMED F, et al.
Pathophysiology, mechanisms, and managements of tissue
hypoxia [J]. Anaesth Crit Care Pain Med, 2022, 41(4): 101087.
[11]DE BACKER D, CRETEUR J, PREISER J-C, et
al. Microvascular blood flow is altered in patients with sepsis [J].
Am J Respir Crit Care Med, 2002, 166(1).
[12]ZHANG D, SHI C, WANG Y, et al. Metabolic
Dysregulation and Metabolite Imbalances in Acute-onchronic Liver Failure: Impact on Immune Status [J]. J Clin
Transl Hepatol, 2024, 12(10): 865-77.
[13]FILHO R R, ROCHA L L, CORRêA T D, et
al. Blood Lactate Levels Cutoff and Mortality Prediction in
Sepsis-Time for a Reappraisal? a Retrospective Cohort Study
[J]. Shock (Augusta, Ga), 2016, 46(5): 480-5.
[14]EVANS L, RHODES A, ALHAZZANI W, et
al. Surviving sepsis campaign: international guidelines for
management of sepsis and septic shock 2021 [J]. Intensive
Care Med, 2021, 47(11): 1181-247.
[15]RYOO S M, LEE J, LEE Y-S, et al. Lactate Level
Versus Lactate Clearance for Predicting Mortality in Patients
With Septic Shock Defined by Sepsis-3 [J]. Critical care
medicine, 2018, 46(6): e489-e95.
[16]WEISS G, GANZ T, GOODNOUGH L T.
Anemia of inflammation [J]. Blood, 2019, 133(1): 40-50.
[17]KAMATH S, HAMMAD ALTAQ H, ABDO T.
Management of Sepsis and Septic Shock: What Have We
Learned in the Last Two Decades? [J]. Microorganisms, 2023,
11(9).
[18]JUNG S M, KIM Y-J, RYOO S M, et al.
Relationship between low hemoglobin levels and mortality in
patients with septic shock [J]. Acute Crit Care, 2019, 34(2):
141-7.
Refbacks
- 当前没有refback。
