天津医药2024,Vol.52Issue(4) :416-421.DOI:10.11958/20230833

实验室衰弱指数对老年CAP住院患者并发脓毒症及脓毒性休克风险的预测价值

The predictive value of laboratory frailty index for the risk of sepsis and septic shock in elderly CAP inpatients

任燕 陈善萍 周莉华 王凌霄 管丽娟 杨永学
天津医药2024,Vol.52Issue(4) :416-421.DOI:10.11958/20230833

实验室衰弱指数对老年CAP住院患者并发脓毒症及脓毒性休克风险的预测价值

The predictive value of laboratory frailty index for the risk of sepsis and septic shock in elderly CAP inpatients

任燕 1陈善萍 1周莉华 1王凌霄 1管丽娟 1杨永学1
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作者信息

  • 1. 成都市第五人民医院(成都中医药大学附属第五人民医院/第二临床医学院)老年医学科,成都市老年疾病研究所/成都市肿瘤防治所(邮编 611137)
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摘要

目的 探讨实验室衰弱指数(FI-LAB)对老年社区获得性肺炎(CAP)住院患者发生脓毒症及脓毒性休克风险的预测价值.方法 回顾性纳入住院的老年CAP患者502例.选取40个入院后24 h内首次采集的常规实验室指标和生命体征指标构建FI-LAB,FI-LAB<0.35为非衰弱组,FI-LAB≥0.35为衰弱组.判定脓毒症和脓毒性休克的发生情况.采用修正Poisson回归构建预测模型并采用受试者工作特征(ROC)曲线分析预测价值.结果 多因素修正Poisson回归分析显示衰弱是老年CAP并发脓毒症和脓毒性休克的危险因素(P<0.001).将FI-LAB乘以100后纳入多因素修正Poisson回归分析,发现FI-LAB每增加0.01,发生脓毒症及脓毒性休克的风险分别增高5.9%和6.2%(均P<0.001).FI-LAB预测脓毒症及脓毒性休克的ROC曲线下面积分别为0.865和0.850,最佳截断值分别为0.28和0.42.结论 衰弱增加CAP并发脓毒症及脓毒性休克的风险.FI-LAB可预测CAP患者发生脓毒症和脓毒性休克的风险,早期发现高危人群.

Abstract

Objective To investigate the value of laboratory frailty index(FI-LAB)in predicting the risk of sepsis and septic shock in elderly hospitalized patients with community-acquired pneumonia(CAP).Methods A total of 502 elderly CAP patients hospitalized in Chengdu Fifth People's Hospital were retrospectively included.Forty routine laboratory indexes and vital signs collected for the first time within 24 hours after admission were selected to construct FI-LAB.Patients with FI-LAB≥0.35 were defined as the frail group,while patients with FI-LAB<0.35 were defined as the non-frail group.The occurrence of sepsis and septic shock was observed.The predictive model was established by modified Poisson regression,and the predictive value was analyzed by the ROC curve of the subjects.Results Multivariate modified Poisson regression analysis showed that frailty was a risk factor for sepsis(P<0.001)and septic shock(P=0.001)in elderly patients with CAP(P<0.001).When FI-LAB was multiplied by 100 and included in the multivariate Poisson regression analysis,it was found that for every 0.01 increase in FI-LAB,the risk of sepsis and septic shock increased by 5.9%and 6.2%(both P<0.001).The area under ROC curve of FI-LAB for predicting sepsis and septic shock was 0.865 and 0.850(both P<0.001),respectively,and the best cut-off values were 0.28 and 0.42,respectively.Conclusion Frailty increases the risk of CAP complications with sepsis and septic shock.FI-LAB can predict the risk of sepsis in CAP patients and detect high-risk groups early.

关键词

脓毒症/休克,脓毒性/肺炎/老年人/衰弱指数

Key words

sepsis/shock,septic/pneumonia/aged/frailty index

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基金项目

四川省医学青年创新科研课题(Q19036)

出版年

2024
天津医药
天津市医学科学技术信息研究所

天津医药

CSTPCD
影响因子:1.107
ISSN:0253-9896
参考文献量25
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