目的 探讨纤维蛋白原与前白蛋白比值(fibrinogen to prealbumin ratio，FPR)在老年脓毒症患者预后评估中的价值。方法 回顾性分析2022年3月—2024年3月郑州大学附属郑州中心医院ICU收治的172例老年脓毒症患者的临床资料。根据28 d存活状态将其分为存活组和死亡组。收集患者的临床资料和实验室指标，并分别计算纤维蛋白原与白蛋白比值(fibrinogen to albumin ratio，FAR)和纤维蛋白原与前白蛋白比值(FPR)。比较各指标在两组中的差异。多因素Cox回归模型探讨影响患者预后的独立危险因素。受试者工作特征曲线(ROC)评价FAR、FPR在预测患者预后中的价值。采用Kaplan-Meier生存曲线比较不同FAR、FPR水平下患者28d累计生存情况。结果 年龄、SOFA评分、FPR是老年脓毒症患者预后不良的独立危险因素。与存活组相比，死亡组FAR、FPR水平升高(P＜0。05)。ROC曲线分析显示，FPR用于预测老年脓毒症患者预后时的诊断效能优于FAR，当FPR与FAR、SOFA评分联合时，诊断效能达到最大，AUC为0。936，明显高于三项指标单独时的诊断效能。Kaplan-Meier生存分析显示，FAR≥0。16组和FPR≥24。2组28d累计生存率明显低于FAR＜0。16组和FPR＜24。2组。结论 FPR可以用于老年脓毒症患者预后评估，且价值优于FAR。
Value of fibrinogen to prealbumin ratio in prognostic assessment of elderly patients with sepsis
Objective To investigate the value of fibrinogen to prealbumin ratio(FPR)in the prognostic assessment of elderly sepsis patients.Methods The clinical data of 172 elderly sepsis patients admitted to our ICU from March 2022 to March 2024 were retrospectively analyzed.They were categorized into survival and death groups based on 28 d surviv-al status.Clinical data and laboratory indices of the patients were collected and the fibrinogen to albumin ratio(FAR)and fibrinogen to prealbumin ratio(FPR)were calculated respectively.The differences of each index in the two groups were compared.Multifactorial Cox regression modeling was performed to explore the independent risk factors affecting patients'prognosis.The value of FAR and FPR in predicting patients'prognosis was evaluated by receiver operating char-acteristic curve(ROC).Kaplan-Meier survival curves were used to compare the 28d cumulative survival of patients at different FAR and FPR levels.Results Age,SOFA score,and FPR were independent risk factors for poor prognosis in elderly sepsis patients.Compared with the survival group,the levels of FAR and FPR were elevated in the death group(P＜0.05).ROC curve analysis showed that the diagnostic efficacy of FPR was better than that of FAR when used to predict the prognosis of elderly sepsis patients,and the diagnostic efficacy reached its maximum when FPR was combined with FAR and SOFA score,with an AUC of 0.936,which was significantly higher than that of the three indexes alone.Kap-lan-Meier survival analysis showed that the 28d cumulative survival rate was significantly lower in the FAR≥0.16 and FPR≥24.2 groups than in the FAR＜0.16 and FPR＜24.2 groups.Conclusion FPR can be used for prognostic assessment in elderly sepsis patients and is of better value than FAR.
ElderlySepsisFibrinogen to albumin ratioFibrinogen to prealbumin ratio
NETL
NSTL
万方数据
