Early stratification of in-hospital mortality risk in adult septic shock patients and development of a simplified scoring system
10.3969/j.issn.1671-8348.2024.05.008
- VernacularTitle:成人脓毒症休克患者院内死亡风险的早期预测及简易评分表构建
- Author:
Qingsong MOU
1
,
2
;
Xiangning REN
;
Jinshuai LU
;
Jing ZHANG
Author Information
1. 新疆医科大学研究生学院,乌鲁木齐 830017
2. 新疆维吾尔自治区人民医院急诊科,乌鲁木齐 830001
- Keywords:
septic shock;
in-hospital mortality;
influencing factors;
survival analysis;
prognosis
- From:
Chongqing Medicine
2024;53(5):682-689,695
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the independent factors impacting the in-hospital prognosis of patients with septic shock,and to construct a simplified scoring system and evaluate its predictive value.Methods A retrospective analysis was carried out on 247 patients with septic shock admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2021 to July 2022,among whom 122 patients survived and 125 died.Univariate analysis and multivariate Cox proportional hazard regression model were used to screen the independent factors affecting in-hospital mortality of septic shock patients.The best cut-off value was ob-tained by using the receiver operating characteristics(ROC)curve,and the continuous variables were conver-ted into binary variables and assigned.Finally,a simplified scoring system was established,and its predictive efficacy for hospital death in septic shock patients was verified.Results The results of multivariate Cox pro-portional hazard regression model showed that the Glasgow coma scale(GCS)score(HR=0.929,95%CI:0.875-0.985,P=0.014),quick sequential organ failure assessment(qSOFA)score(HR=1.475,95%CI:1.094-1.989,P=0.011),lactate level(HR=1.096,95%CI:1.049-1.145,P<0.001),procalcitonin level(HR=1.009,95%CI:1.000-1.018,P=0.048),and albumin level(HR=0.958,95%CI:0.922-0.996,P=0.029)were identified as independent influencing factors for in-hospital mortality in patients with septic shock.The ROC curve showed that the simplified scoring system,based on GCS score,qSOFA score,lactate,procalcitonin,and albumin levels,exhibited an area under the curve and 95%CI of 0.866(0.822-0.910),with an optimal cutoff value of 2.5.The sensitivity and specificity were 80.0%and 78.7%,respectively.Con-clusion The simplified scoring system,based on early assessments of GCS score,qSOFA score,lactate,pro-calcitonin,and albumin levels,demonstrates substantial predictive value for in-hospital mortality in patients with septic shock.
