Evaluation value of plasminogen activator inhibitor-1 combined with C-reactive protein to albumin ratio for 28-day prognosis in elderly patients with sepsis
Evaluation value of plasminogen activator inhibitor-1 combined with C-reactive protein to albumin ratio for 28-day prognosis in elderly patients with sepsis
Objective To investigate predictive value of plasminogen activator inhibitor-1(PAI-1)combined with C-reactive protein to albumin ratio(CAR)for 28-day prognosis in elderly patients with sepsis.Methods A total of 90 elderly patients with sepsis were selected as study group,and 30 healthy elderly individuals who underwent physical examinations during the same period were selected as control group.Plasma PAI-1 level and CAR were compared between study group on the day after admission and control group on the day of physical examination.Leukocyte count,platelet count and lymphocyte count of study group were recorded.Sequential Organ Failure Score(SOFA)and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score were calculated.The association of plasma PAI-1 levels and CAR with the severity of the elderly patients with sepsis were analyzed.Using general information of survival and death groups of the elderly patients with sepsis(based on their 28-day survival outcome),laboratory indexes,plasma PAI-1,and CAR,multiple logistic regression analysis was used to identify independent risk factors affecting the 28-day prognosis of elderly sepsis patients.The predictive values of plasma PAI-1 and CAR on the 28-day prognosis of the elderly patients with sepsis were evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).Results Plasma PAI-1 level and CAR in study group were higher than those in control group(P＜0.05).There were significantly positive associations of plasma PAI-1,CAR,and SOFA score with APACHE Ⅱ score in the elderly patients with sepsis,respectively(P＜0.05).Within 28 days,31 elderly patients with sepsis died(34.44％)and 59 survived(65.56％).Lymphocyte count in survival group was higher than that in death group,while SOFA score,plasma PAI-1 level and CAR were lower than those in death group(P＜0.05).Multivariate logistic regression analysis showed that plasma PAI-1 level and CAR were independent risk factors affecting the 28-day prognosis of the elderly patients with sepsis(P＜0.05).ROC curve analysis displayed that AUCs of plasma PAI-1,CAR,and their combination were 0.752(95％CI was 0.642-0.862,P＜0.001),0.842(95％CI was 0.745-0.939,P＜0.001)and 0.887(95％CI was 0.796-0.977,P＜0.001)in predicting the mortality within 28 days in the elderly patients with sepsis,respectively.Conclusion Plasma PAI-1 level and CAR in the elderly patients with sepsis are significantly elevated,and their combination has good predictive value for the 28-day prognosis of the patients.
维普
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