Study on the Changes of PT,NLR,PCT/ALB and Their Relationship with Prognosis in Sepsis Patients with Different Etiological Results of Bloodstream Infections
Objective:To investigate the changes of prothrombin time(PT),neutrophil/lymphocyte ratio(NLR),and procalcitonin/albumin(PCT/ALB)in sepsis patients with different etiological results of bloodstream infection(BSI)and their relationship with prognosis.Methods:130 sepsis patients with BSI admitted to the Shanghai Fifth People's Hospital Affiliated to Fudan University from January 2021 to March 2023 were selected,and they were divided into fungal group with 11 cases,gram-positive bacteria(G+bacteria)group with 49 cases and gram-negative bacteria(G-bacteria)group with 70 cases according to different etiological results.Sepsis patients with BSI were divided into death group with 36 cases and survival group with 94 cases according to the 28d clinical outcome.The PT,NLR,PCT/ALB were detected and calculated.Multivariate Logistic regression was used to analyze the factors affecting the prognosis of sepsis patients with BSI,and receiver operating characteristics(ROC)curve was used to analyze the predictive value of PT,NLR,PCT/ALB in predicting death in sepsis patients with BSI.Results:The PT of G-bacteria group was longer than that of fungal group and G+bacteria group,and the NLR and PCT/ALB were higher than those of fungal group and G+bacteria group(P＜0.05).There were no differences in PT,NLR and PCT/ALB between fungal group and G+bacteria group(P＞0.05).Multivariate Logistic regression analysis showed that septic shock,PT prolongation,Sequential Organ failure assessment(SOFA)score elevated,Acute physiological and Chronic Health Assessment Ⅱ(APACHE Ⅱ)score elevated,NLR elevated,PCT/ALB elevated were independent risk factors for the prognosis of sepsis patients with BSI(P＜0.05).ROC curve analysis showed that the area under the curve of PT,NLR and PCT/ALB combined predicted the death of sepsis patients with BSI was 0.897,which was larger than that predicted by PT,NLR and PCT/ALB alone(P＜0.05).Conclusion:Compare with fungi and G+bacteria,PT,NLR and PCT/ALB of Gbacteria in sepsis patients with BSI are significantly elevated,and the PT,NLR and PCT/ALB elevated are independent risk factors affecting the prognosis of sepsis patients with BSI,and the combination of the three has higher predictive value for the prognosis of sepsis patients with BSI.
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