The predictive value of heparin-binding protein combined with pediatric sequential organ failure assessment score in the prognosis of sepsis in children
10.3760/cma.j.issn.1673-4912.2024.08.011
- VernacularTitle:肝素结合蛋白联合儿童序贯器官功能衰竭评分对儿童脓毒症预后的预测价值
- Author:
Xiaoshun WANG
1
;
Yimin ZHU
;
Shuqiong LIU
;
Pei WU
;
Yinggang PENG
;
Huimin ZHU
;
Yanmei CHEN
;
Saizhen ZENG
Author Information
1. 湖南省人民医院(湖南师范大学附属第一医院)儿童医学中心，长沙 410005
- Keywords:
Children;
Pediatric sequential organ failure assessment;
Heparin binding protein;
Sepsis;
Prognosis
- From:
Chinese Pediatric Emergency Medicine
2024;31(8):614-618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of heparin binding protein(HBP) combined with pediatric sequential organ failure assessment(pSOFA) in children with sepsis.Methods:Children with sepsis admitted to PICU of Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) from January 2021 to June 2022 were selected as study group,while those who underwent elective surgery for inguinal hernia and assessment of precocious puberty and short stature during the same period were selected as control group.All children with sepsis were divided into sepsis group and septic shock group according to their severity as well as survival group and death group according to prognosis.The study group was monitored for HBP on the 1st,3rd,and 7th day of admission,while the control group was monitored for HBP on the 1st day of admission.Patients in the sepsis group received pSOFA scores immediately after admission.The laboratory results and HBP concentrations were compared between groups，and a joint model was established in combination with pSOFA to observe its predictive performance in sepsis prognosis.Results:A total of 50 children with sepsis were included in study group，including 45 children with sepsis and five children with septic shock.There were 27 males and 23 females，aged 1 month～13 years（median age two years）.There were 7 deaths in this study，including two patients with sepsis and five patients with septic shock.The HBP concentration in the study group was significantly higher than that in the control group on the 1st day，and the HBP concentration in the group gradually decreased with the prolongation of hospital stay.The concentration of HBP on the first day of septic shock group was higher than that of sepsis group，and the difference was statistically significant（ P<0.001）.The concentration of HBP on the 1st day in the sepsis death group was significantly higher than that in the sepsis survival group（ P=0.023）.The receivor operator characteristic curve analysis showed that HBP and pSOFA had good predictive value for the death of children with sepsis，and the joint model of HBP and pSOFA（75.1×pSOFA-0.1×HBP）had the best predictive performance for the death of children with sepsis，but there was no significant difference with the pSOFA. Conclusion:The HBP level significantly increases in children with sepsis，and gradually decreases with the length of hospital stay，and HBP has great value in predicting the outcome of death in children with sepsis，and the combination of pSOFA could improve its predictive ability of death,but not better than pSOFA.
