Correlation of blood cell parameters and hs-CRP levels with q SOFA scores and prognosis in patients with acute upper gastrointestinal bleeding
Objective To explore the correlation of blood cell parameters and high-sensitivity C-reactive protein(hs-CRP)levels with the quick sequential organ failure assessment(q SOFA)scores and prognosis in patients with acute upper gastro-intestinal bleeding(AUGIB),aiming to provide a reference for the clinical treatment and prognostic assessment of AUGIB patients.Methods A retrospective analysis was conducted on the clinical data of 120 AUGIB patients treated at the 2nd Af-filiated Hospital of Chengdu Medical College from January 2022 to January 2024.Patients were assigned to groups based on their q SOFA scores at admission:q SOFA=0(n=60),q SOFA=1(n=23),q SOFA=2(n=25),and q SOFA=3(n=12).The platelet-to-lymphocyte ratio(PLR),neutrophil-to-lymphocyte ratio(NLR),and hs-CRP levels were compared a-mong the four groups.Pearson correlation analysis was used to assess the relationship between PLR,NLR,hs-CRP,and q SOFA scores.Patients were further allocated to poor prognosis(n=56)and good prognosis(n=64)groups based on ma-jor clinical outcomes within 28 days of admission.Logistic regression models were used to analyze factors influencing poor prognosis,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of PLR,NLR,and hs-CRP for the prognosis of AUGIB patients.Results Significant differences were noted in NLR and hs-CRP levels among patients with different q SOFA scores(P<0.05).LSD-t test results showed that patients in the q SOFA=3 group had sig-nificantly higher PLR and NLR levels than those in the q SOFA=0 group(P<0.05).Kruskal-Wallis one-way ANOVA test results indicated that hs-CRP levels in the q SOFA=2 and q SOFA=3 groups were significantly higher than those in the q SOFA=0 group(H=3.028,3.968,both P<0.05).Pearson correlation analysis results demonstrated that PLR,NLR,and hs-CRP levels in AUGIB patients were positively correlated with q SOFA scores(r=0.289,P=0.003;r=0.316,P=0.001;r=0.295,P<0.001).No significant differences were found in body mass index(BMI),comorbid chronic disea-ses,systolic blood pressure,diastolic blood pressure,heart rate,shock index,neutrophil count,or the incidence of gastric ulcer,acute erosive hemorrhagic gastritis,and consciousness disorders between AUGIB patients with different prognoses(P>0.05).The proportion of patients aged≥60 years,female,with esophageal and gastric varices,and anemia,as well as q SO-FA scores,NLR,and hs-CRP levels were higher in the poor prognosis group than in the good prognosis group,while the pro-portion of patients with duodenal ulcer and platelet count(PLT)and lymphocyte count levels were lower in the poor progno-sis group,with statistically significant differences(P<0.05).Logistic stepwise regression analysis indicated that age≥60 years,q SOFA score,PLR,NLR,and hs-CRP were independent influencing factors for poor prognosis in AUGIB patients(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for predicting poor prognosis in AUGIB pa-tients using a combination of hs-CRP,PLR,and NLR was 0.849(95%CI:0.772-0.908),which was higher than that of single indicator detection.Conclusion PLR,NLR,and hs-CRP are positively correlated with the severity of AUGIB.Fur-thermore,PLR,NLR,and hs-CRP have certain predictive values for the prognosis of AUGIB patients,and the predictive value of the combined detection of the three indicators is higher;detection of PLR,NLR,and hs-CRP can enable early iden-tification and stratification of AUGIB,thereby aiding in the treatment and management of AUGIB.
万方数据
维普
