Analysis of clinical characteristics and risk factors of sepsis-induced liver injury
Objective To investigate the clinical characteristics and related risk factors of patients with sepsis-induced liver injury.Methods The clinical data of 678 patients with sepsis who were admitted to the Intensive Care Unit of the 908t h Hospital of the PLA Joint Logistics Support Force from May 2018 to December 2022 were retrospectively analyzed.According to the presence of acute liver injury within 2 hours of admission,the enrolled patients were divided into two groups:the general sepsis group(n=563)and the sepsis-induced liver injury group(n=115).Logistic regression analysis was used to analyze the risk factors for sepsis-induced liver injury,and the ROC curve was drawn to evaluate their predictive value for sepsis-induced liver injury.Results The platelet count(PLT)and albumin level in patients with sepsis-induced liver injury were significantly lower compared to those in the general sepsis group.Conversely,levels of plasma alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin,serum creatinine,C-reactive protein(CRP),lactate,prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrin degradation products(FDP),D-dimer,thrombomodulin(TM),thrombin-antithrombin complex(TAT),and tissue plasminogen activator-inhibitor complex(t-PAIC)were significantly higher,with these differences being statistically significant(P<0.05).Multivariate logistic regression analysis showed that t-PAIC,PLT,and CRP were independent risk factors for sepsis-induced liver injury(P<0.05).The receiver operating characteristic(ROC)curve analysis revealed that the area under the curve(AUC)for predicting sepsis-induced liver injury was 0.699[95%confidence interval(CI):0.645～0.754,P<0.001]for t-PAIC,0.665(95%CI:0.610～0.720,P<0.001)for PLT,0.640(95%CI:0.584～0.697,P<0.001)for CRP,and 0.797(95%CI:0.752～0.841,P<0.001)for the combination of all three,respectively.Conclusion Decreased PLT,elevated plasma levels of t-PAIC and CRP are independent risk factors for sepsis-induced liver injury.Additionally,the combined use of these three factors demonstrates considerable diagnostic value for identifying sepsis-induced liver injury.
NETL
NSTL
万方数据
维普
