摘要
目的 探讨年龄休克指数(ageSI)联合中性粒细胞与淋巴细胞比值(NLR)对老年脓毒症预后的预测价值。方法选取2020年7月至2022年1月丽水市人民医院收治的144例老年脓毒症患者为研究对象,根据入院28 d预后情况分为存活组101例和死亡组43例,比较两组患者临床资料,分析老年脓毒症预后的影响因素。采用ROC曲线分析ageSI、NLR及两者联合对老年脓毒症患者预后的预测效能,并以NLR、ageSI最佳截断点为界分组,比较组间28 d病死率的差异。结果 存活组与死亡组患者PLT、血清白蛋白、尿素氮、血肌酐、ageSI及NLR比较,差异均有统计学意义(均P<0.05);而性别、年龄、基础疾病、主要感染部位、WBC、Hb、血钠、血钾、CRP比较,差异均无统计学意义(均P>0.05)。ageSI(OR=1.057)、NLR(OR=1.055)、PLT(OR=0.993)是老年脓毒症患者预后的独立影响因素(均P<0.05)。ageSI、NLR及两者联合预测老年脓毒症患者预后的AUC分别为0.743、0.730、0.780,差异无统计学意义(P>0.05);ageSI、NLR预测老年脓毒症患者预后的最佳截断值分别为70.8、14.63。ageSI≥70.8组患者NLR及28 d病死率均明显高于ageSI<70.8组(均P<0.05);NLR≥14.63组患者ageSI及28 d病死率均明显高于NLR<14.63组(均P<0.05)。结论 ageSI、NLR对老年脓毒症患者的预后有较高的预测价值。
Objective To investigate the prognostic value of age shock index(ageSI)and neutrophil to lymphocyte ratio(NLR)in elderly patients with sepsis.Methods A total of 144 elderly patients with sepsis admitted to Lishui People's Hospital from July 2020 to January 2022 were enrolled in the study.Within 28 days after admission,101 patients survived(survival group)and 43 patients died(death group).The clinical data of the two groups were compared,and the influencing factors of the prognosis were analyzed.ROC curve was used to analyze the predictive efficacy of ageSI,NLR and their combination for the prognosis of elderly patients with sepsis.The best cut-off points of NLR and ageSI were used as the boundary groups to compare the difference of 28-day mortality between the groups.Results There were significant differences in PLT,serum albumin,urea nitrogen,serum creatinine,ageSI and NLR between survival group and death group(all P<0.05).There were no significant differences in gender,age,underlying diseases,main infection sites,WBC,Hb,blood sodium,blood potassium and CRP between two groups(all P>0.05).AgeSI(OR=1.057),NLR(OR=1.055)and PLT(OR=0.993)were independent predicting factors for prognosis of patients(all P<0.05).The AUCs of ageSI,NLR and their combination in predicting the prognosis of elderly patients with sepsis were 0.743,0.730 and 0.780,respectively(P>0.05).The optimal cut-off values of ageSI and NLR for predicting the prognosis were 70.8 and 14.63,respectively.The NLR and 28-day mortality in patients with ageSI≥70.8 were significantly higher than those with ageSI<70.8(all P<0.05).The ageSI and 28-day mortality in patients with NLR≥14.63 were significantly higher than those with NLR<14.63(all P<0.05).Conclusion AgeSI and NLR have certain predictive value for the prognosis of elderly patients with sepsis.
作者
朱斌
潘笑
金毅
ZHU Bin;PAN Xiao;JIN Yi(Department of Emergency Medicine,Lishui People's Hospital,Lishui 323000,China)
出处
《浙江医学》
CAS
2023年第6期577-580,共4页
Zhejiang Medical Journal
基金
浙江省康恩贝医院管理软科学研究项目(2020ZHA-KE337)。
