The value of APACHE Ⅱ score combined with PA,PCT,and IL-6 in evaluating the condition and prognosis of patients with traumatic shock and infection
Objective To explore the relationship between the condition of patients with traumatic shock accompanied by infection and the acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ),serum prealbumin(PA),procalcitonin(PCT),and interleukin-6(IL-6),and analyze the predictive value of the above indicators for disease prognosis.Methods A total of 120 cases of traumatic shock admitted to the Emergency Medicine Department of Taihe county People's Hospital from August 2021 to August 2023 were selected as the study subjects,with co-infection as the observation group(n=80)and no co-infection as the control group(n=40).Patients in the observation group were divided into mild group(without multiple organ dysfunction,n=48)and severe group(with multiple organ dysfunction,n=32)based on their disease condition.They were further divided into a good prognosis group(significantly improved discharge condition,n=43)and a poor prognosis group(died or hospitalized in the ICU for more than 1 month,n=37)based on 28 days of death.APACHE Ⅱ scores and serum levels of PA,PCT,and IL-6 were determined in the observation group and control group after 2 hours of admission.APACHE Ⅱ scores and serum levels of PA,PCT,and IL-6 were determined in the subgroups of the observation group after 7 days of treatment.Receiver operating characteristic(ROC)curve analysis was used to evaluate the severity of traumatic shock with infection and predict its prognosis.Results After 2 h of admission,APACHE Ⅱ score,serum PCT and IL-6 levels in the observation group were higher than those in the control group,and serum PA level was lower than that of the control group,the differences were statistically significant(t=2.033,2.315,2.467,2.303;all P＜0.05);APACHE Ⅱ score,serum PCT and IL-6 levels were lower than those in the severe group,and serum PA was higher than that of the severe group,the differences were statistically significant(t=4.073,7.002,5.987,4.774;all P＜0.05).After 7 d of treatment,the APACHE Ⅱ score,serum PCT,and IL-6 levels in the good prognosis group were lower than those in the poor prognosis group,and the PA level was higher than that of the poor prognosis group,the differences were statistically significant(t=2.382,3.123,2.857,4.195;all P＜0.05).The ROC curve analysis results showed that the AUC values of APACHE Ⅱ score,serum PA,PCT,IL-6 levels,and their combination for assessing the severity of traumatic shock with infection in patients admitted for 2 hours were 0.762(95％CI:0.654-0.850),0.811(95％CI:0.707-0.890),0.799(95％CI:0.694-0.880),0.839(95％CI:0.739-0.911),and 0.943(95％CI:0.868-0.983),respectively,And the AUC values of a single factor were all lower than the value of combined factors(Z=3.311,3.009,2.567,2.737;all P＜0.05).The ROC curve analysis results showed that the AUC values of APACHE Ⅱ score,serum PA,PCT,IL-6 levels,and their combination for predicting the prognosis of traumatic shock with infection in patients after 7 days of treatment were 0.621(95％CI:0.506-0.727),0.656(95％CI:0.541-0.758),0.670(95％CI:0.556-0.771),0.664(95％CI:0.550-0.766),and 0.804(95％CI:0.700-0.884),respectively.And the AUC values of single factor were all lower than that of the combined factors(Z=3.219,3.053,2.957,2.955;all P＜0.05).Conclusion The combination of APACHE Ⅱ score,PA,PCT,and IL-6 had certain reference value for evaluating the severity and prognosis of patients with traumatic shock and infection.
Traumatic shockAcute physiology and chronic health status scoring system ⅡPrealbuminProcalcitoninInterleukin-6
NETL
NSTL
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