Background: Studies have shown that a variety of blood inflammatory markers can be used to assess the criticality of patients with sepsis. In this study, the blood inflammatory factors related to the sepsis survival group and the death group were compared and analyzed, which can be used by clinicians to adjust sepsis patient treatment.
Methods: This study used retrospective methods to analyze the medical records of 428 patients with sepsis. The test of blood samples includes the patient's age, gender, hospital stays, the concentration of procalcitonin (PCT), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), D-dimer (DD), Fe3+, and hemoglobin (Hb) in the venous blood of patients with sepsis. The detection of PCT methods adopts the sandwich immunofluorescence (IF). ROC curve was used for the diagnosis and analysis of various factors of sepsis.
Results: Among all the patients with sepsis, 133 patients died, with a mortality rate of 31.07%. Analysis of related inflammatory indicators and the patient's baseline parameters showed the patients age, the values of PCT, ANC, NLR, and DD in death group were statistically higher than those in survival group (all p values were <0.05). However, the concentration of Fe3+ and ALC show an opposite trend between the two groups. Regression analysis results showed the patient's gender, Fe3+, PCT, ANC, and DD are all independent prognostic factors for patients with sepsis. The results of the ROC curve of related diagnostic indicators show that DD has the best area under curve (AUC=0.700), the most sensitive index is ANC (74.44), and the most specific index is PCT (89.80). The results of the two-by-two combined diagnosis of the four indicators showed that the PCT+DD group had better AUC (0.748) and specificity (78.23), and the Fe3++DD group had the best sensitivity (75.89).
Conclusion: In this study, the patient's gender and the inflammation-related markers of Fe3+, PCT, ANC, and DD can be used as independent risk factors affecting the prognosis of patients with sepsis. The combination of PCT+DD and Fe3++DD has high diagnostic value for patients with sepsis.
Keywords: D-dimer; Fe3+; diagnosis; immunocyte; procalcitonin; sepsis.
© 2021 Wang et al.