Analysis of Predictive Value of Peripheral Blood PCT,D-dimer,NLR and SII on the Prognosis in Patients with Sepsis
Objective:To explore the predictive value of peripheral blood procalcitonin(PCT),D-dimer(D-D),neutrophil-to-lymphocyte ratio(NLR)and systemic immune-inflammation index(SII)on the prognosis in patients with sepsis.Method:The clinical data of 82 patients with sepsis in Ji'an Central People's Hospital from June 2019 to June 2023 were retrospectively analyzed.According to the presence or absence of shock,they were divided into septic non-shock group(n=51)and septic shock group(n=31).The basic data,acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,sequential organ failure assessment(SOFA)and levels of serum PCT,D-D,NLR and SII were compared between both groups of patients.The risk factors of septic shock were analyzed by logistic regression analysis,and receiver operating characteristic(ROC)curve was adopted to describe the predictive efficiency of the above indicators on the prognosis in patients with sepsis.Result:The levels of NLR,SII,PCT and D-D,APACHEⅡ score and SOFA in septic non-shock group were lower than those in septic shock group,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that SOFA score[OR=1.244,95%CI(1.020,1.516),P=0.031],APACHEⅡ score[OR=2.404,95%CI(1.359,4.252),P=0.003],PCT[OR=2.492,95%CI(1.428,4.348),P=0.001],D-D[OR=2.073,95%CI(1.548,2.776),P<0.001],NLR[OR=1.053,95%CI(1.015,1.093),P=0.005]and SII[OR=2.370,95%CI(1.249,4.499),P=0.009]were independent risk factors for septic shock.The cut-off values of serum PCT,D-D,NLR and SII for predicting the prognosis in patients with sepsis were 10.42 μg/mL,5.07 mg/L,11.94 and 951.84 respectively.The combined prediction ROC area under the curve(AUC)was 0.984[95%CI(0.927,0.999)],with a sensitivity of 93.55%and a specificity of 98.04%.Conclusion:Peripheral blood PCT,D-D,NLR and SII are closely related to the prognosis of sepsis.Early combined detection and early warning can be used to take targeted prevention and treatment.
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