Predictive value of PCSK9 combined with lactate acid and SOFA score for mortality risk in patients with sepsis
- VernacularTitle:PCSK9联合乳酸及SOFA评分对脓毒症患者死亡风险的预测价值
- Author:
Yan YAN
1
;
Ziwei DENG
;
Chengfeng QIU
Author Information
- Publication Type:Journal Article
- Keywords: sepsis; organ dysfunction scores; lactic acid; PCSK9; 28-day mortality
- From: Tianjin Medical Journal 2025;53(7):684-688
- CountryChina
- Language:Chinese
- Abstract: Objective To assess the predictive value of proprotein convertase subtilisin/kexin type-9(PCSK9)combined with lactic acid(Lac)and Sequential Organ Failure Assessment(SOFA)score in determining the 28-day mortality risk of patients with sepsis.Methods A total of 203 patients with sepsis were followed up for 28 days.Patients were divided into the death group(n=56)and the survival group(n=147)according to the clinical outcome.The general data and clinical indicators were compared between the two groups.The prediction model of 28 day mortality risk of sepsis patients was established by multivariate Logistic regression analysis,and the nomogram of the prediction model visualization was drawn.Results Alanine aminotransferase,serum creatinine,blood urea nitrogen,Lac,PCSK9 and SOFA score were higher in the death group than those in the survival group(P＜0.05),while the hemoglobin level was lower than that in the survival group(P＜0.05).The multivariable Logistic regression analysis identified that elevated levels of Lac(OR=1.197,95％CI:1.019-1.435),PCSK9(OR=1.002,95％CI:1.001-1.003)and SOFA score(OR=1.858,95％CI:1.528-2.340)were independent risk factors for 28-day mortality in patients with sepsis(P＜0.05).Nomogram was developed using these three indicators,and the linear predictor cutoff value was-1.06.Patients were divided into the low-risk group(n=126)and the high-risk group(n=77).The 28-day mortality rates were 4.0％for the low-risk group and 66.2％for the high-risk group.Internal validation showed that the model with these three indicators had good discrimination(C-index=0.924,95％CI:0.881～0.960,P＜0.05),calibration(x2=11.543,P＞0.05)and clinical utility.Conclusion The combination of serum PCSK9,Lac and SOFA scores at admission effectively predicts 28-day mortality risk in sepsis patients.
