Correlation analysis of SOFA score, serum hs-CRP, D-dimer and prognosis of patients with sepsis-induced acute respiratory distress syndrome
10.3760/cma.j.cn101721-20230619-000221
- VernacularTitle:序贯器官衰竭评分、血清超敏C反应蛋白及D二聚体与脓毒症所致急性呼吸窘迫综合征患者预后的相关分析
- Author:
Fawei YUAN
1
;
Dong LIU
Author Information
1. 湖北省黄石市中心医院 湖北理工学院附属医院重症医学科 肾脏疾病发生与干预湖北省重点实验室,黄石 435000
- Keywords:
Sepsis;
Sequential organ failure score;
High-sensitivity C-reactive protein;
D-dimer;
Acute respiratory distress syndrome;
Prognosis
- From:
Clinical Medicine of China
2024;40(3):196-201
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between sequential organ failure score (SOFA), serum high-sensitivity C-reactive protein (hs-CRP), D-dimer and prognosis of sepsis-induced acute respiratory distress syndrome (ARDS) patients and their joint prediction effect.Methods:Clinical data of 76 patients with sepsis complicated with ARDS diagnosed and treated in Department of Intensive Care Unit, Huangshi Central Hospital from May 2019 to May 2022 were retrospectively analyzed, and were divided into death group ( n=24) and survival group ( n=52) according to the prognosis 28 days after admission. The SOFA score, hs-CRP and D-dimer levels were compared. Independent sample t-test was used for inter group comparison of metric data that conforms to normal distribution, while χ 2 test was used for inter group comparison of count data. Binary Logistic regression model was used to analyze the risk factors affecting the prognosis of patients with ARDS caused by sepsis. The ROC curve model was used to analyze the AUC value, sensitivity and specificity of SOFA score, hs-CRP and D-D in predicting death during hospitalization in patients with sepsis complicated with ARDS. Results:In the death group, SOFA score was (6.63±1.91), hs-CRP score was (108.82±30.71) mg/L, D-dimer score was (5.17±1.53) mg/L. The survival group was (4.04±1.33), (71.11±18.18) mg/L, and (3.08±0.60) mg/L, respectively, and there were significant differences between the two groups ( t=6.84, 6.70, 8.57, all P<0.001). Binary Logistic regression analysis showed that SOFA score ( OR=2.671, 95 CI 1.726-4.135, P<0.001), hs-CRP ( OR=1.080, 95 CI 1.038-1.123, P<0.001), D-D ( OR=5.491, 95 CI 2.499-12.069, P<0.001) was an independent risk factor for the prognosis of ARDS patients with sepsis. ROC curve analysis showed that the AUC values of SOFA score, hs-CRP, D-dimer and their combination in predicting the prognosis of ARDS patients with sepsis were (0.847, 0.833, 0.867, 0.978, all P<0.001). The sensitivity was 75.00%, 62.50%, 75.00%, 87.50%; the specificity was 88.50%, 98.10%, 98.10%, 96.20%, respectively. The comparison of SOFA score with the AUC of the three-item combination, Z=2.346, P=0.018; the comparison of the AUC of the D-D and the three-item combination, Z=2.346, P=0.044; the comparison of the AUC of hs-CRP and the three-item combination, Z=2.146, P=0.03. Conclusion:SOFA score and serum hs-CRP and D-dimer levels will increase with ARDS in patients with sepsis, and dynamic monitoring of their changes can provide an important reference for prognosis evaluation.
